Initial Experience with the Eclipse Double-lumen Balloon Catheter for Embolization of Cranial Vascular Malformations

Abstract

Double lumen balloon catheters (DLBCs) have emerged as a potential alternative to single lumen balloon catheters (SLBCs) for endovascular embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs). This study describes our preliminary experience with the Eclipse 2L DLBC in treating AVMs and dAVFs. Patients who underwent embolization of cranial dAVFs or AVMs at our institution from August 2021 to March 2024 were included. Spinal vascular malformations were excluded. Descriptive statistics were used to analyze procedural outcomes, technical nuances and post-operative outcome on follow-up. 25 patients who underwent 38 embolization procedures (15 AVMs and 23 dAVFs) met criteria for inclusion in this study. The mean age of the cohort was 52.44 (standard deviation (SD)= 17.26), and 48% of the overall cohort (n= 13) was female. The average procedure times for AVMs and dAVFs were 80.4 minutes and 96.73 minutes, respectively. There was one instance of catheter entrapment. Two patients in the AVM cohort experienced mortality and one experienced post-operative rupture. Our preliminary experience using the Eclipse 2L balloon catheter for Onyx embolization reported procedural outcomes comparable to other DLBCs despite relatively higher procedure times and radiation doses. Further long-term studies on its efficacy as primary modality in treating AVMs and dAVFs are encouraged.