• Neurosurgery · May 2016

    Onyx Embolization for Isolated Type Dural Arteriovenous Fistula Using a Dual-Lumen Balloon Catheter.

    • Jin Woo Kim, Byung Moon Kim, Keun Young Park, Dong Joon Kim, and Dong Ik Kim.
    • Departments of *Radiology and‡Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
    • Neurosurgery. 2016 May 1; 78 (5): 627-36.

    BackgroundUtilization of a dual-lumen balloon may improve Onyx penetration into isolated dural arteriovenous fistulas (i-DAVFs).ObjectiveTo compare the results of Onyx embolization using a dual-lumen balloon with those using a non-balloon catheter for i-DAVFs.MethodsTwenty-nine patients underwent Onyx embolization for i-DAVFs using a non-balloon (n = 14) or a dual-lumen balloon catheter (n = 15). Since its introduction, a dual-lumen balloon catheter has been preferred. We compared the dual-lumen balloon group with the non-balloon catheter group regarding angiographic outcome, treatment-related complications, total procedural time, Onyx injection time, and the number of feeders requiring embolization.ResultsThe dual-lumen balloon group showed complete occlusion of i-DAVFs in 13 and near-complete in 2 patients, while the non-balloon group showed complete occlusion in 5, near-complete in 5, and incomplete in 4 patients (P < .05). Treatment-related complications occurred in 2 patients: 1 in the non-balloon group and 1 in the dual-lumen balloon group. The mean total procedural time was 62 ± 32 minutes in the dual-lumen balloon and 171 ± 88 minutes in the non-balloon group (P < .05). The mean Onyx injection time was 10 ± 6 minutes in the dual-lumen balloon and 49 ± 32 minutes in the non-balloon group (P < .05). The median number of feeders requiring embolization was 1 (range, 1-3) in the dual-lumen balloon and 2 (range, 1-4) in the non-balloon group (P < .05).ConclusionUtilization of a dual-lumen balloon catheter for Onyx embolization of i-DAVF seemed to significantly increase the immediate complete occlusion rate and decrease total procedural time, Onyx injection time, and number of feeders requiring embolization.

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