Transarterial embolization in dural arteriovenous fistulas under sinus balloon protection using the SHOURYU supercompliant balloon

Abstract

Objective: Transarterial embolization under intrasinus balloon protection is an efficient treatment strategy for intracranial arteriovenous fistula. Ordinary balloon protection methods using the Copernic RC balloon may occlude the normal drainage route, and the occurrence of venous complications is concerning. The aim of this study was to report the efficacy of the supercompliant SHOURYU balloon catheter for intrasinus balloon protection while preserving the normal venous outlet. Methods: Eighteen patients with dural arteriovenous fistulas who were treated with transarterial embolization under intrasinus balloon protection between April 2011 and July 2020 were included. All lesions were treated with transarterial embolization under intrasinus balloon protection using the SHOURYU balloon catheter. Clinical and angiographic data were retrospectively collected, and the occlusion rate, complications, and clinical outcomes were analyzed. Results: Nine men and nine women were treated, and their average age was 61.1 years. Fistulas were located at the transverse-sigmoid sinus (n = 13), superior sagittal sinus (n = 3), tentorial sinus (n = 1), and around the torcular Herophili (n = 1). Ten patients were classified as Borden typeⅠand eight as Borden type Ⅱ. Complete (n = 9) or near-complete (n = 4) occlusion was achieved in 72.2% of the patients. Periprocedural complications, but no venous complications were observed in two patients. Symptoms were not aggravated after treatment. Conclusions: Transarterial embolization under intrasinus balloon protection using the SHOURYU balloon catheter is effective and safe for treatment of dural arteriovenous fistulas while maintaining the patency of the venous sinus.

Keywords

• Fistula
• Occlusion
• Supercompliant balloon
• Transvenous embolization
• Transarterial embolization