Onyx embolization of a pial AV fistula with a giant venous varix using a flow-directed Scepter balloon catheter: Technical note.

Journal Article (Journal Article)

BACKGROUND AND IMPORTANCE: Pial arteriovenous fistulas (AVFs) of the brain are treacherous lesions that can be challenging to treat because of high risk of hemorrhage. We report on a rare case of a pial AVF with a giant venous varix as a draining vein treated successfully with flow-directed balloon-assisted Onyx embolization. CLINICAL PRESENTATION: A 56-year-old female with headaches underwent brain magnetic resonance imaging, which demonstrated a 4 cm aneurysmal malformation in the right temporal lobe. A diagnostic cerebral angiogram demonstrated a right temporal pial AVF fed by an enlarged right posterior cerebral artery with drainage into a giant venous varix. Onyx embolization was curative using a flow-directed Scepter balloon catheter. CONCLUSION: Flow-directed balloon-assisted Onyx embolization can be highly successful for the curative embolization of pial AVFs. Balloon application changes the nature of the lesion from high-flow-high risk to no-flow-low-risk. Using a flow-directed technique with balloon microcatheters may help minimize the risk of intracranial vascular injury.

Full Text

Duke Authors

Cited Authors

  • Griffin, AS; Befera, N; Hauck, E

Published Date

  • December 2018

Published In

Volume / Issue

  • 24 / 6

Start / End Page

  • 702 - 705

PubMed ID

  • 29921152

Pubmed Central ID

  • PMC6259346

Electronic International Standard Serial Number (EISSN)

  • 2385-2011

Digital Object Identifier (DOI)

  • 10.1177/1591019918781670


  • eng

Conference Location

  • United States