Efficacy analysis of balloon assisted with Onyx18 for embolization of superior sagittal sinus and lateral sinus in the treatment of dural arteriovenous fistula

Objective: To investigate the reliability, safety and effectiveness of balloon-assisted with Onyx18 for embolization of superior sagittal sinus and lateral sinus (transverse sinus and sigmoid sinus) in the treatment of dural arteriovenous fistula (DAVF). Methods: The clinical data of 24 patients using protection balloons via arterial and/or the intravenous approaches for the treatment of DAVF in superior sagittal sinus and lateral sinus with Onyx18 were analyzed retrospectively from February 2008 to June 2012. The results of balloon-assisted embolization and procedure-related complications were analyzed. Results: Circled digit oneOf the 24 patients in this group, the lesion sites of 5 patients were in the superior sagittal sinus and 19 were in the lateral sinus. Hyperform 7 x 7 mm balloon was used in superior sagittal sinus lesion and lateral sinus lesion in 1 patient each. Peripheral vascular dilatation balloons were used in all of the remaining patients. Circled digit two 3 patients with superior sagittal sinus lesion were embolized via arterial approach, and 2 via venous approach. The venous sinuses were almost embolized with balloons. Ten patients with lateral sinus lesion were embolized via arterial approach, 7 via venous approach, and 2 via both arterial and venous approaches. The venous sinuses were almost embolized in 8 patients and were partially embolized in 11 patients with balloons. Circled digit three 3 patients with superior sagittal sinus lesion were cured, 2 of them showed no recurrence after following up for 6 months, and 1 had a few residuals after embolization. Angiography showed no significant change after 1 year. Among patients with lateral sinus lesion, the fistula disappeared in 1 patient after 2 sessions of embolization, and the remaining patients were cured by one session. Seven of them were followed up with angiography after 6 months, and no recurrence was observed. Conclusion: The balloon-assisted embolization of lateral sinus (transverse sinus and sigmoid sinus) and superior sagittal sinus in the treatment of DAVF with Onyx18 are a relatively safe and effective method. It may maximumly maintain the venous sinus patency.