J O Zamponi, F P Trivelato1, M T S Rezende2, R K Freitas3, L H de Castro-Afonso3, G S Nakiri3, T G Abud4, A C Ulhôa2, D G Abud3. 1. From the Division of Interventional Neuroradiology (J.O.Z., F.P.T., M.T.S.R., A.C.U.), Felício Rocho Hospital, Belo Horizonte, Minas Gerais, Brazil felipepadovani@yahoo.com.br. 2. From the Division of Interventional Neuroradiology (J.O.Z., F.P.T., M.T.S.R., A.C.U.), Felício Rocho Hospital, Belo Horizonte, Minas Gerais, Brazil. 3. Division of Interventional Neuroradiology (R.K.F., L.H.d.C.-A., G.S.N., D.G.A.), Hospital das Clínicas, Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 4. Division of Interventional Neuroradiology (T.G.A.), Hospital Israelita Albert Einstein, São Paulo, Brazil.
Abstract
BACKGROUND AND PURPOSE: Treatment of dural arteriovenous fistulas can be performed by transarterial or transvenous accesses. For those fistulas located at a dural sinus wall, obliteration of the sinus might lead to a substantial risk of complications if the occluded sinus impairs normal venous drainage. For those fistulas with direct leptomeningeal venous drainage, navigation to reach the arteriovenous shunting point of a leptomeningeal vein is usually technically demanding. We report the outcomes of patients with dural AVFs treated by transarterial injection of liquid embolic agents assisted by transarterial double-lumen balloon catheters and/or transvenous balloon catheters. MATERIALS AND METHODS: This was a retrospective, 3-center study including patients with dural AVFs treated with a balloon-assisted technique in at least 1 treatment session. Angiographic follow-up was performed at 6 months. Clinical assessment was performed at admission and discharge and was reassessed at 30-day and 6-month follow-ups. RESULTS: Forty-one patients with 43 dural AVFs were treated. Thirty-four fistulas were located at a dural sinus wall. Treatment was performed using only a transarterial approach in 42 fistulas. Only 1 session was needed for complete obliteration of the fistula in 86% of the patients. Immediate complete angiographic occlusion was achieved in 39 fistulas. Of the 41 controlled fistulas, 40 (97.6%) were completely occluded at 6 months. Thirty-nine fistulas (95.1%) were cured without any report of major neurologic events or death during follow-up. CONCLUSIONS: Transarterial balloon-assisted treatment of dural AVFs with or without transvenous balloon protection was shown to be safe and effective.
BACKGROUND AND PURPOSE: Treatment of dural arteriovenous fistulas can be performed by transarterial or transvenous accesses. For those fistulas located at a dural sinus wall, obliteration of the sinus might lead to a substantial risk of complications if the occluded sinus impairs normal venous drainage. For those fistulas with direct leptomeningeal venous drainage, navigation to reach the arteriovenous shunting point of a leptomeningeal vein is usually technically demanding. We report the outcomes of patients with dural AVFs treated by transarterial injection of liquid embolic agents assisted by transarterial double-lumen balloon catheters and/or transvenous balloon catheters. MATERIALS AND METHODS: This was a retrospective, 3-center study including patients with dural AVFs treated with a balloon-assisted technique in at least 1 treatment session. Angiographic follow-up was performed at 6 months. Clinical assessment was performed at admission and discharge and was reassessed at 30-day and 6-month follow-ups. RESULTS: Forty-one patients with 43 dural AVFs were treated. Thirty-four fistulas were located at a dural sinus wall. Treatment was performed using only a transarterial approach in 42 fistulas. Only 1 session was needed for complete obliteration of the fistula in 86% of the patients. Immediate complete angiographic occlusion was achieved in 39 fistulas. Of the 41 controlled fistulas, 40 (97.6%) were completely occluded at 6 months. Thirty-nine fistulas (95.1%) were cured without any report of major neurologic events or death during follow-up. CONCLUSIONS: Transarterial balloon-assisted treatment of dural AVFs with or without transvenous balloon protection was shown to be safe and effective.
Authors: René Chapot; Paul Stracke; Aglaé Velasco; Hannes Nordmeyer; Markus Heddier; Michael Stauder; Petra Schooss; Pascal J Mosimann Journal: J Neuroradiol Date: 2014-01-07 Impact factor: 3.447
Authors: D F Vollherbst; C Ulfert; U Neuberger; C Herweh; M Laible; S Nagel; M Bendszus; M A Möhlenbruch Journal: AJNR Am J Neuroradiol Date: 2018-05-03 Impact factor: 3.825
Authors: C Cognard; Y P Gobin; L Pierot; A L Bailly; E Houdart; A Casasco; J Chiras; J J Merland Journal: Radiology Date: 1995-03 Impact factor: 11.105