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Scepter dual-lumen balloon catheter for Onyx embolization for dural arteriovenous fistula

 Chang Ki Jang  ;  Byung Moon Kim  ;  Keun Young Park  ;  Jae Whan Lee  ;  Dong Joon Kim  ;  Joonho Chung  ;  Jun-Hwee Kim 
 BMC NEUROLOGY, Vol.21(1) : 31, 2021-01 
Journal Title
Issue Date
Adult ; Catheters* ; Central Nervous System Vascular Malformations / therapy* ; Dimethyl Sulfoxide ; Embolization, Therapeutic / instrumentation* ; Embolization, Therapeutic / methods ; Female ; Humans ; Male ; Middle Aged ; Polyvinyls ; Retrospective Studies ; Treatment Outcome
Dual‐lumen balloon catheter ; Dural arteriovenous fistula ; Onyx embolization
Background: This study aimed to evaluate the efficacy and safety of Scepter dual-lumen balloon catheter for transarterial Onyx embolization of dural arteriovenous fistula (DAVF). Methods: Transarterial Onyx embolization using a Scepter dual-lumen balloon catheter (Scepter-assisted Onyx embolization) for DAVF was attempted in a total of 35 patients (mean age, 52.5 years; M:F = 24:11) between October 2012 and December 2018. The results of Scepter-assisted Onyx embolization were evaluated with respect to total procedural and Onyx injection times, the types and number of feeders requiring embolization, angiographic and clinical outcomes, and treatment-related complications. Results: Initial presentations were non-hemorrhagic neurological deficits in 10, intracranial hemorrhage in 8, seizure in 7, headache in 7, and intractable tinnitus in 3. All DAVF were aggressive type (Borden type 2, 14.3 %; type 3, 85.7 %). Scepter-assisted Onyx embolization resulted in immediately complete occlusion in 33 patients (94.3 %) and near complete occlusion in 2 patients. Middle meningeal artery (51.4 %) was the most commonly used for Scepter-assisted technique, followed by occipital artery (42.9 %), ascending pharyngeal artery (2.9 %) and superficial temporal artery (2.9 %). There was no difference in complete occlusion rate between middle meningeal artery and the other arteries (94.4 % versus 94.1 %). The median number of total feeders embolized was 1 (range, 1-3). The median total procedural time was 45 minutes (range, 21 minutes - 127 minutes) and the median Onyx injection time was 11 minutes (range, 3 minutes - 25 minutes). All patients recovered completely (n = 31) or partially (n = 4) from presenting symptoms. Treatment-related complications occurred in 2 patients, of whom one had a permanent morbidity (2.8 %, ipsilateral facial nerve palsy). No patient showed a recurrence on follow-up imaging (median, 15 months; range, 3-56 months). Conclusions: Scepter-assisted transarterial Onyx embolization showed a very high complete occlusion rate with a low morbidity and no recurrence in aggressive type DAVF. Scepter dual-lumen balloon catheter seems to be a useful tool for transarterial Onyx embolization of DAVF.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Jun-Hwee(김준휘)
Park, Keun Young(박근영)
Lee, Jae Whan(이재환)
Jang, Chang Ki(장창기) ORCID logo https://orcid.org/0000-0001-8715-8844
Chung, Joon Ho(정준호)
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