Balloon-assisted endovascular treatment of intracranial dural arteriovenous fistulas

Abstract

Objective To report experiences in balloon-assisted endovascular Onyx embolization of intracranial dural arteriovenous fistulas (DAVFs).Methods Clinical records of 6 DAVFs patients treated with balloon-assisted endovascular Onyx embolization were retrospectively collected to analyze their presenting symptoms,angiographic features,endovascular treatments,and clinical outcomes.Results Four patients were presented with cortical venous reflux.Five patients underwent transarterial and one patient underwent transvenous Onyx embolization adjunct to transarterial balloon protection.The balloons were use to protect ICA in 4 patients,to protect VA in 1 patient,and to prevent Onyx reflux in MMA in 1patient.Angiograms obtained immediately after embolization demonstrated complete transarterial obliteration of the fistula in 4 patients and partial occlusion in 2.One patient had Onyx embolization-relatted complication of transient hemi-facial hypoesthesia.Conclusions Balloon adjunct to Onyx embolization can provide protection of the intracranial artery in the treatment of intracranial DAVFs with double blood supply from intracranial and extracranial arteries.Balloons could prevent Onyx reflux and decrease the flow rate of fistula when placed into the blood supply artery. Key words: Dural arteriovenous fistula; Embolization ; Balloon ; Onyx