Clinical use of a new mechanical detachable coil system for percutaneous intravenous embolization of cavernous sinus dural arteriovenous fistulas.

PURPOSE

The purpose of this study was to evaluate the usefulness of a new mechanical detachable coil system (Detach-18/-11) for percutaneous transvenous embolization (TVE) of dural arteriovenous fistulas (AVFs) involving the cavernous sinus.

MATERIALS AND METHODS

Five patients with dural AVF involving the cavernous sinus were treated by TVE with the use of the Detach-18/-11 system alone. All procedures were analyzed with regard to the processes of introduction, delivery, and/or retrieval of the Detach-18/-11 system, and angiographical and clinical outcome.

RESULTS

A total of 70 detachable coils (37 spiral-type coils and 33 J-type coils) were used. Two coils were easily retrieved after introduction. The remaining 68 coils were easily delivered within 30 seconds. Neither premature detachment nor coil migration was observed. Of the five dural AVFs, three were completely occluded and two were nearly completely occluded immediately after embolization. Follow-up angiography showed complete occlusion in all cases. Clinical symptoms had disappeared within one month, and no recurrent symptoms were observed during follow-up (from 5 to 36 months).

CONCLUSION

Our results support the safety and reliability of the Detach-18/-11 system for TVE of dural AVF. The availability of various types of this coil system allows sufficient packing of the involved sinus.