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New devices and techniques
Original research
Transarterial embolization of dural arteriovenous fistulas of the lateral sinuses with stent-assisted sinus protection
  1. Alexis Guédon1,2,3,
  2. Mahmoud Elhorany1,4,
  3. Marc-Antoine Labeyrie1,
  4. Vittorio Civelli1,
  5. Jean-Pierre Saint-Maurice1,
  6. Emmanuel Houdart1,3
  1. 1 Department of Neuroradiology, Lariboisière Hospital, AP-HP, Paris, France
  2. 2 INSERM UMR_S 1140, University of Paris, Paris, France
  3. 3 University of Paris, Paris, France
  4. 4 Department of Neurology, Faculty of Medicine, Tanta University, Tanta, Egypt
  1. Correspondence to Dr Alexis Guédon, Department of Interventional Neuroradiology, Hopital Lariboisière Service de Neuroradiologie 2, rue Ambroise Paré, 75010, Paris, France; alexisguedon{at}live.fr

Abstract

Background The balloon-assisted sinus protection technique has been described as a sinus-preserving technique during transarterial embolization (TAE) of dural arteriovenous fistulas (DAVFs). However, some serious complications of this technique have been documented.

Objective To describe our preliminary experience with a new technique called stent-assisted sinus protection (SSP).

Methods We performed a retrospective analysis of seven consecutive patients with type I or IIa DAVFs of the lateral sinus treated by TAE with a closed-cell stent temporarily deployed in the sinus.

Results Of the seven patients, four had type I DAVF, and three had type IIa DAVF. The patency of all involved sinuses and their tributaries (including the inferior anastomotic vein and the superior petrosal sinus) was preserved. At the end of the procedure, all stents were successfully retrieved with embolic particles trapped in their meshes. No procedural complications were noted. Clinical follow-up was satisfactory, with complete resolution or significant reduction of pulsatile tinnitus.

Conclusions SSP appears to be feasible and probably safe. However, larger studies are needed to confirm these preliminary results.

  • stent
  • fistula
  • liquid embolic material
  • technique
  • angiography

Data availability statement

Data are available upon reasonable request. Not applicable.

https://doi.org/10.1136/neurintsurg-2021-018176

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    Data availability statement

    Data are available upon reasonable request. Not applicable.

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    Footnotes

    • Contributors Conception and design: AG, EH. Acquisition of data: AG, ME, EH. Analysis and interpretation of data: AG, ME, EH. Drafting the article: AG, ME, EH. Critical revision of the article: M-AL, VC, J-PS-M. Review of submitted version of manuscript: AG, ME, M-AL, VC, J-PS-M, EH. Approval of the final version of the manuscript on behalf of all authors: AG. Author acting as guarantor : AG.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.