A Damp-and-Push Technique for the Copolymer (Onyx) Embolization of Dural Arteriovenous Fistula |
| |
| Authors: | Yoshihiro Omura Hirotoshi Imamura Shoichi Tani Hidemitsu Adachi Ryu Fukumitsu Tadashi Sunohara Nobuyuki Fukui Natsuhi Sasaki Tatsumaru Fukuda Tomoaki Akiyama Shinji Kajiura Masashi Shigeyasu Kento Asakura Ryo Horii Nobuyuki Sakai |
| |
| Institution: | 2. Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Chile;3. Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Chile;4. Unidad de Investigación y Ensayos Clínicos, Departamento de Desarrollo Académico e Investigación, Clínica Alemana de Santiago, Facultad de Medicina Universidad Finis Terrae, Chile;5. Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría y Departamento de Paciente Critico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile;2. Beth Israel Deaconess Medical Center, Department of Radiology, 330 Brookline Avenue, Boston, MA 02215-5400, USA;2. Department of Neurology, Jinling Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu Province, China;3. Radiology Department, Changzhou No. 2 People''s Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu Province, China;4. Radiology Department, Nanjing First People''s Hospital Affiliated to Nanjing Medical University, Jiangsu Province, China;2. Departments of Cardiothoracic Surgery, University of Michigan, Ann Arbor, Michigan;3. Departments of Radiology, University of Michigan, Ann Arbor, Michigan;4. Departments of Neurology, University of Michigan, Ann Arbor, Michigan;2. Division of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland;3. Division of Neurology, Geneva University Hospitals, Geneva, Switzerland;4. Division of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland;2. Department of Neurosurgery, NYU Langone Medical Center, New York, New York, USA;3. Department of Epidemiology and Neurology, Columbia University Irving Medical Center, New York, New York, USA;4. Department of Neurology, Brown University School of Medicine, Providence, RI, USA |
| |
| Abstract: | BackgroundCopolymer (Onyx) embolization is an effective treatment for dural arteriovenous fistula (dAVF), however, some dAVFs have multiple, high-flow feeding vessels, resulting in insufficient embolization. For the treatment of such patients, we have developed a novel flow-control technique, the ‘damp-and-push technique’. The purpose of this study was to evaluate the technical efficiency and safety of this technique.MethodsSeven patients who had been diagnosed with intracranial dAVF were treated by transarterial Onyx embolization using the damp-and-push technique between 2016 and 2019. This technique was designed to reduce blood flow to the shunt site using a balloon catheter in the major feeding vessel other than the one injected with Onyx, leading to better Onyx penetration and enabling more controlled embolization of complex dAVFs. Retrospectively collected data were reviewed to assess the occlusion rates and clinical outcomes.ResultsThe dAVF was at a transverse sinus-sigmoid sinus junction in four patients, in the superior sagittal sinus in two, and in the tentorium in one. Five cases were Cognard type Ⅱb and two cases were Cognard type Ⅳ. All the patients were treated by transarterial Onyx injection via the main feeding vessel, combined with flow reduction in the other main feeding vessel using a balloon catheter. Complete occlusion was achieved in six patients and elimination of cerebral venous reflux was achieved in all the patients. There were no immediate or delayed post-interventional complications.ConclusionsTransarterial Onyx embolization of dAVF using the damp-and-push technique is safe and yields a high complete occlusion rate. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
