Bharathi D Jagadeesan1,2,3, Andrew W Grande1,2,3, Ramachandra P Tummala1,2,3. 1. Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA. 2. Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA. 3. Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA.
Abstract
BACKGROUND/ OBJECTIVE: Compliant dual-lumen balloon microcatheters have been used to perform balloon-assisted embolization (BAE) of brain arteriovenous malformations (AVMs) with ethylene vinyl alcohol copolymer (Onyx). However, vessel rupture and microcatheter retention have been reported from BAE using these microcatheters. Using an extra-compliant balloon microcatheter (Scepter XC; Microvention, Tustin, CA, USA) could help avoid pial vessel rupture during BAE. We herein report our experience using this balloon microcatheter for BAE. METHODS: This retrospective study included patients who underwent BAE of brain AVMs at our institution between June 2012 and March 2017. RESULTS: The extra-compliant Scepter XC balloon microcatheter was used for BAE of brain AVMs in 23 patients aged 44.3 ± 16.7 years (range 0-65 years). A total of 40 intracranial vessels (39 pial arteries and 1 pial vein) were catheterized and embolized during 30 separate sessions. In all instances, the balloon microcatheter could be successfully advanced to the AVM nidus. A mean volume of 2.4 ± 1.7 mL (range 0.65-4.6 mL) of Onyx was injected per session. There were no instances of vessel rupture, microcatheter retention, or stroke. CONCLUSION: Utilization of the extra-compliant balloon microcatheter results in safe and effective BAE, which adds to the growing experience with BAE for AVM treatment.
BACKGROUND/ OBJECTIVE: Compliant dual-lumen balloon microcatheters have been used to perform balloon-assisted embolization (BAE) of brain arteriovenous malformations (AVMs) with ethylene vinyl alcohol copolymer (Onyx). However, vessel rupture and microcatheter retention have been reported from BAE using these microcatheters. Using an extra-compliant balloon microcatheter (Scepter XC; Microvention, Tustin, CA, USA) could help avoid pial vessel rupture during BAE. We herein report our experience using this balloon microcatheter for BAE. METHODS: This retrospective study included patients who underwent BAE of brain AVMs at our institution between June 2012 and March 2017. RESULTS: The extra-compliant Scepter XC balloon microcatheter was used for BAE of brain AVMs in 23 patients aged 44.3 ± 16.7 years (range 0-65 years). A total of 40 intracranial vessels (39 pial arteries and 1 pial vein) were catheterized and embolized during 30 separate sessions. In all instances, the balloon microcatheter could be successfully advanced to the AVM nidus. A mean volume of 2.4 ± 1.7 mL (range 0.65-4.6 mL) of Onyx was injected per session. There were no instances of vessel rupture, microcatheter retention, or stroke. CONCLUSION: Utilization of the extra-compliant balloon microcatheter results in safe and effective BAE, which adds to the growing experience with BAE for AVM treatment.
Authors: Bharathi D Jagadeesan; Haralabos Zacharatos; David R Nascene; Andrew W Grande; Daniel J Guillaume; Ramachandra P Tummala Journal: J Neurosurg Pediatr Date: 2016-04-08 Impact factor: 2.375
Authors: Alejandro M Spiotta; Robert F James; Stephen R Lowe; Jan Vargas; Aquilla S Turk; M Imran Chaudry; Tarun Bhalla; Rashid M Janjua; John J Delaney; Stacey Quintero-Wolfe; Raymond D Turner Journal: J Neurointerv Surg Date: 2014-08-12 Impact factor: 5.836
Authors: Bharathi D Jagadeesan; Mikayel Grigoryan; Ameer E Hassan; Andrew W Grande; Ramachandra P Tummala Journal: Neurosurgery Date: 2013-12 Impact factor: 4.654