Endovascular embolization is the mainstay for treatment of infantile dural sinus malformations.1 2 Distal access and flow control are limiting factors in controlled embolization.3–6 The Scepter mini catheter (Microvention, Aliso Viejo, California, USA) is a low-profile, dual-lumen balloon microcatheter designed to provide navigability in small-caliber, tortuous intracranial vessels. In this technical video, we demonstrate the staged embolization of a dural sinus malformation with multiple arteriovenous fistulae using the Scepter mini catheter (video 1). In the newborn patient, embolizations were performed through the parietal branches of the left and right middle meningeal arteries. The catheter easily navigated into the small feeding arteries. No neurological complications occurred due to the procedures. Post-embolization injections demonstrated significant flow reduction into the malformation. Three-month follow-up angiography illustrated resolution of the previously dilated left transverse sinus. Complete obliteration of the dural sinus malformation was achieved in the newborn patient.
- Arteriovenous Malformation
- Liquid Embolic Material
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Twitter @StavrosMatsouk, @cprossitto
SM and CPR contributed equally.
Contributors SM and CPR contributed equally to this paper. SM: acquisition of images and videos, creation of the video, revising, and final approval of the video. CPR: narration, drafting, revising, and final approval of the video. AB: performing the surgical procedure and final approval of the video. JTF: performing the surgical procedure, acquisition of images and videos, revising, and final approval of the video. All authors acknowledge that they are accountable for all aspects of the work.
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 JTF is a consultant to Microvention and on the editorial board of JNIS.
Provenance and peer review Not commissioned; externally peer reviewed.