A comparison of dual-lumen balloon and simple microcatheters in the embolization of DAVFs and AVMs using onyx.
Publication/Presentation Date
11-1-2020
Abstract
Endovascular embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs) has become the mainstay in treatment for these pathologies. Traditional techniques required the formation of a proximal plug of Onyx around the microcatheter prior to embolization to avoid reflux. Recently, dual-lumen balloon catheters have been introduced as a potential solution to this issue. We sought to compare our institutional experience with dual-lumen balloons to traditional microcatheters in the endovascular embolization of AVMs and DAVFs. A retrospective analysis of consecutive patients treated with Scepter between 2016 and 2020 was obtained. A control cohort treated with Marathon between 2012 and 2020 was also obtained. Variables collected included patient demographics, procedure times, pedicles treated, operative complications, obliteration rate, and retreatment rate. A total of 44 trial (30 DAVFs and 14 AVMs) and 25 control (15 DAVFs and 10 AVMs) subjects were identified. Average Scepter procedure times were 66.0 and 68.0 min for DAVFs and AVMs, respectively. Average Scepter volume of Onyx injected was 2.2 and 1.4 mL for DAVFs and AVMs, respectively. Complete angiographic occlusion Scepter rate was 86.7% and 50.0% for DAVFs and AVMs, respectively. The Scepter retreatment rate was 13.3% and 50.0% for DAVFs and AVMs, respectively. Predictors of angiographic occlusion included the number of pedicles (OR 0.54, 95%CI 0.30-0.97, p = 0.04). Predictors of retreatment included DAVF (OR 0.16, 95%CI 0.04-0.66, p = 0.01) and Marathon (OR 3.34, 95%CI 1.00-11.56, p = 0.05). Our study shows that dual-lumen balloon catheters are a viable option in the embolization of DAVFs and AVMs.
Volume
81
First Page
295
Last Page
301
ISSN
1532-2653
Published In/Presented At
Hafazalla, K., Baldassari, M. P., Sweid, A., Starke, R., Sajja, K., Lebovitz, J., Storey, C., Herial, N., Tjoumakaris, S., Gooch, M. R., Zarzour, H., Rosenwasser, R., & Jabbour, P. (2020). A comparison of dual-lumen balloon and simple microcatheters in the embolization of DAVFs and AVMs using onyx. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 81, 295–301. https://doi.org/10.1016/j.jocn.2020.10.007
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
33222933
Department(s)
Administration and Leadership
Document Type
Article