Analysis of the efficacy of anterior skull base dural arteriovenous fistula with balloon-assisted Onyx glue embolization
Objective To explore the safety and effectiveness of balloon-assisted embolization of anterior skull base dural arteriovenous fistula(DAVF)through different blood supply arteries.Methods The clinical data of 9 patients with anterior skull base DAVF who underwent balloon-assisted embolization at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University from January 2002 to December 2022 were retrospectively analyzed.Nine patients underwent balloon-assisted Onyx glue embolization via the sphenopalatine artery,ophthalmic artery,and middle meningeal artery respectively,with 10 procedures in total.During the operation,complete occlusion of the proximal drainage vein by the embolic agent was considered as the criterion for immediate complete embolization.The safety of the procedure was evaluated based on the patient's comorbidity profile.Clinical follow-up was performed after surgery,and the modified Rankin Scale(mRS)was used to evaluate the clinical outcomes of the patients.Imaging follow-up was performed through digital subtraction angiography(DSA)examination to determine whether the fistulas recurred.Results Seven of the 9 fistulas were completely embolized,and two were nearly completely occluded.One of the nine patients had central retinal artery ischemia after embolization via the ophthalmic artery,while the remaining 8 patients had no complications.All 9 patients were followed up for a period ranging from 59 to 127 months.The mRS was 0 in 7 cases and 1 in 2.Six patients performed imaging follow-up for a period ranging from 6 to 71 months.More than 3 months later,the patient with near-total occlusion received the examination of DSA,which indicated that the fistula was self-occluded.After complete embolization,5 patients underwent DSA review,and none had recurrence.Conclusion When a microcatheter is unable to reach the fistula in an anterior cranial fossa DAVF,balloon-assisted Onyx embolization is feasible and effective treatment with minor complications.
万方数据
维普
