Occipital artery: a not so poor artery for the embolization of lateral sinus dural arteriovenous fistulas with Onyx

We read with interest the technical note by Chiu et al1 presenting their single center experience in the treatment of dural arteriovenous fistulas (dAVFs) using double-lumen balloon catheters for liquid embolic agent injection. This case series presents six cases of dAVFs (3 Cognard type IV; 2 type III; and 1 type IIa+b2) embolized through the middle meningeal artery (MMA) via a double-lumen compliant balloon (Scepter C; Microvention, Tustin, California, USA). This technique seems useful and effective. However, we think that the navigation of this type of balloon catheter, and especially its inflation in such a small artery, might be associated with a significant risk of complications. As shown in Figure 3 in the paper, this technique may lead to rupture of the MMA that can result in severe complications such as acute epidural hematoma. We do not see a great advantage in using these...

from ! Medicine by Alexandros G. Sfakianakis via a.lsfakia on Inoreader http://ift.tt/2sXC97V
via IFTTT