Transvenous balloon-protected embolization of a scalp arteriovenous fistula using Onyx liquid embolic
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Richard T. Z. Dalya i , Clemens M. Schirmer , Adel M. Malek
- چاپ و سال / کشور: 2011
Description
Background Scalp arteriovenous fistulas (AVFs) are rare and potentially complex lesions that can be treated in a multimodal fashion. We present here the first successful treatment of a Stage Ib scalp AVF using a balloonprotected, retrograde transvenous embolization with the liquid embolic Onyx. Method We describe the case of a 60-year-old man with a scalp AVF that had a fine, diffuse, serpiginous arterial supply, precluding a transarterial approach, and multiple venous drainage paths, including the external jugular vein (EJV). The lesion was successfully embolized exclusively via a femoral transvenous retrograde approach using Onyx with balloon-protection of the EJV to simultaneously prevent pulmonary embolism and enable improved retrograde casting of the fistula-outflow zone. Findings The combined use of Onyx with proximal balloon-protection in a transvenous retrograde femoral approach is a novel method that can be used to definitively treat scalp AVFs with a defined catheter-accessible venous outflow. Conclusion This technique may be useful when transarterial embolization, direct puncture, or surgical excision are not practical or possible
Acta Neurochir (2011) 153:1285–1290 DOI 10.1007/s00701-011-0998-1 Received: 7 December 2009 / Accepted: 14 March 2011 / Published online: 9 April 2011 # Springer-Verlag 2011
