Dabus Guilherme, Linfante Italo, Martínez-Galdámez Mario
Division of NeuroInterventional Surgery, Baptist Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, USA.
Division of NeuroInterventional Surgery, Baptist Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, USA.
Clin Neurol Neurosurg. 2014 Feb;117:22-27. doi: 10.1016/j.clineuro.2013.12.001. Epub 2013 Dec 7.
We report our results of our experience using transarterial balloon-assisted embolization of aggressive DAVFs using a dual lumen balloon microcatheter. The advantages and disadvantages of this technique when compared to different Onyx embolization techniques are discussed.
All patients with aggressive DAVFs who were treated with Onyx using transarterial balloon-assisted technique with a dual lumen balloon microcatheter were included. Clinical presentation, location of DAVF, Borden type, dual lumen balloon microcatheter used, amount of Onyx used, Onyx injection duration, complications, immediate angiographic and follow up results were included in the analysis.
Five patients fulfilled the selection criteria. Their ages ranged from 24 to 62 years old. In 4 cases the dual lumen balloon microcatheter was a Scepter-C 4mm×10mm (Microvention, Tustin, CA); in the other patient the device used was an Ascent 4mm×10mm (Codman, Raynham, MA). In all 5 patients the dual lumen balloon microcatheter was used with the objective to cure the lesion and it was successful in all 5 cases. There was no vessel injury, unwanted embolization, retained microcather, microcatheter rupture or cranial nerve deficits in our series. Our mean Onyx injection time was 6.4min (range from 2 to 10min). There were no procedural complications in our series. Four out of 5 patients had angiographic follow up demonstrating persistent angiographic cure (follow up mean 6 months - range 4-7 months).
Our experience in this small series of patients indicates that the use of dual lumen balloon microcatheters is safe and feasible, facilitating the use of Onyx for embolization of DAVFs.
我们报告使用双腔球囊微导管经动脉球囊辅助栓塞侵袭性硬脑膜动静脉瘘（DAVF）的经验结果。讨论了该技术与不同的Onyx栓塞技术相比的优缺点。
纳入所有使用双腔球囊微导管经动脉球囊辅助技术用Onyx治疗的侵袭性DAVF患者。分析内容包括临床表现、DAVF的位置、Borden分型、使用的双腔球囊微导管、Onyx用量、Onyx注射持续时间、并发症、即刻血管造影及随访结果。
5例患者符合入选标准。年龄范围为24至62岁。4例使用的双腔球囊微导管为Scepter-C 4mm×10mm（Microvention公司，加利福尼亚州图斯廷）；另1例患者使用的是Ascent 4mm×10mm（Codman公司，马萨诸塞州雷纳姆）。所有5例患者使用双腔球囊微导管的目的均为治愈病变，且全部成功。本系列中无血管损伤、意外栓塞、微导管滞留（原文“retained microcather”可能有误，推测为“retained microcatheter”）、微导管破裂或脑神经功能缺损。我们的平均Onyx注射时间为6.4分钟（范围为2至10分钟）。本系列中无手术并发症。5例患者中有4例进行了血管造影随访，显示血管造影持续治愈（随访平均6个月 - 范围4至7个月）。
我们在这一小系列患者中的经验表明，使用双腔球囊微导管安全可行，便于使用Onyx栓塞DAVF。
