Scepter dual-lumen balloon catheter for Onyx embolization for dural arteriovenous fistula.

Abstract

BACKGROUND:

This study aimed to evaluate the efficacy and safety of Scepter dual-lumen balloon catheter for transarterial Onyx embolization of dural arteriovenous fistula (DAVF).

METHODS:

Transarterial Onyx embolization using a Scepter dual-lumen balloon catheter (Scepter-assisted Onyx embolization) for DAVF was attempted in a total of 35 patients (mean age, 52.5 years; M:F = 24:11) between October 2012 and December 2018. The results of Scepter-assisted Onyx embolization were evaluated with respect to total procedural and Onyx injection times, the types and number of feeders requiring embolization, angiographic and clinical outcomes, and treatment-related complications.

RESULTS:

Initial presentations were non-hemorrhagic neurological deficits in 10, intracranial hemorrhage in 8, seizure in 7, headache in 7, and intractable tinnitus in 3. All DAVF were aggressive type (Borden type 2, 14.3 %; type 3, 85.7 %). Scepter-assisted Onyx embolization resulted in immediately complete occlusion in 33 patients (94.3 %) and near complete occlusion in 2 patients. Middle meningeal artery (51.4 %) was the most commonly used for Scepter-assisted technique, followed by occipital artery (42.9 %), ascending pharyngeal artery (2.9 %) and superficial temporal artery (2.9 %). There was no difference in complete occlusion rate between middle meningeal artery and the other arteries (94.4 % versus 94.1 %). The median number of total feeders embolized was 1 (range, 1-3). The median total procedural time was 45 minutes (range, 21 minutes - 127 minutes) and the median Onyx injection time was 11 minutes (range, 3 minutes - 25 minutes). All patients recovered completely (n = 31) or partially (n = 4) from presenting symptoms. Treatment-related complications occurred in 2 patients, of whom one had a permanent morbidity (2.8 %, ipsilateral facial nerve palsy). No patient showed a recurrence on follow-up imaging (median, 15 months; range, 3-56 months).

CONCLUSIONS:

Scepter-assisted transarterial Onyx embolization showed a very high complete occlusion rate with a low morbidity and no recurrence in aggressive type DAVF. Scepter dual-lumen balloon catheter seems to be a useful tool for transarterial Onyx embolization of DAVF.

• Authors: Chang Ki Jang, Byung Moon Kim, Keun Young Park, Jae Whan Lee, Dong Joon Kim, Joonho Chung, Jun-Hwee Kim
• Journal: BMC neurology (BMC Neurol) Vol. 21 Issue 1 Pg. 31 (Jan 20 2021) ISSN: 1471-2377 [Electronic] England
• PMID: 33472604 (Publication Type: Journal Article)

Chemical References

• Onyx copolymer
• Polyvinyls
• Dimethyl Sulfoxide

Topics

• Adult
• Catheters
• Central Nervous System Vascular Malformations (therapy)
• Dimethyl Sulfoxide
• Embolization, Therapeutic (instrumentation, methods)
• Female
• Humans
• Male
• Middle Aged
• Polyvinyls
• Retrospective Studies
• Treatment Outcome