Skip to main content

Advertisement

SpringerLink
Log in

High-Grade Dural Arteriovenous Fistulas

Use of Kaneka ED Coils with the Marathon Microcatheter for Transvenous Coil Embolization

  • Original Article
  • Published:
Clinical Neuroradiology Aims and scope Submit manuscript

Abstract

Background

Dural arteriovenous fistulas (DAVF) are commonly encountered lesions that can be treated both transvenously, transarterially or using a combined approach.

Objective

Transvenous coil embolization of DAVF is a recognized treatment option but can be challenging. In this context this article presents clinical experience using the Kaneka ED10 ExtraSoft coils in combination with the Marathon microcatheter to treat high grade DAVF. The physical properties of these coils and the microcatheter were also determined.

Material and Methods

All patients with high grade DAVF treated with the Marathon and the Kaneka ED COIL ∞10 ExtraSoft coils were retrospectively identified. The clinical presentation, location, grade of the lesion, clinical and radiological follow-up data were recorded. Bench side studies were performed to determine the physical properties of the Marathon catheter in comparison to the SL10 and Headway Duo as well the maximum width of the Kaneka pusher wire in comparison to Hypersoft, Target and Axium Prime coils.

Results

A total of 8 patients with 9 DAVF with 3 Cognard 3 and 6 Cognard 4 lesions were identified. All the DAVF’s were occluded either at the end of the procedure or on follow-up imaging. On bench side tests the Marathon microcatheter had the most flexible distal tip and distal shaft in comparison to the SL10 and Headway Duo. The proximal shaft of the Marathon was stiffer than the SL10. The Kaneka ED COIL ∞10 ExtraSoft had the smallest distal width and were the only coils tested that could be deployed through a Marathon microcatheter.

Conclusion

The combination of the Marathon microcatheter and Kaneka ED COIL ∞10 ExtraSoft is useful for the treatment of high grade DAVF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Kutluk K, Schumacher M, Mironov A. The role of sinus thrombosis in occipital dural arteriovenous malformations−development and spontaneous closure. Neurochirurgia (Stuttg). 1991;34:144–7.

    CAS  Google Scholar 

  2. Lawton MT, Jacobowitz R, Spetzler RF. Redefined role of angiogenesis in the pathogenesis of dural arteriovenous malformations. J Neurosurg. 1997;87:267–74.

    Article  CAS  Google Scholar 

  3. Zhu Y, Lawton MT, Du R, Shwe Y, Chen Y, Shen F, Young WL, Yang GY. Expression of hypoxia-inducible factor-1 and vascular endothelial growth factor in response to venous hypertension. Neurosurgery. 2006;59:687–96. discussion 687–696.

    Article  Google Scholar 

  4. Klisch J, Kubalek R, Scheufler KM, Zirrgiebel U, Drevs J, Schumacher M. Plasma vascular endothelial growth factor and serum soluble angiopoietin receptor sTIE-2 in patients with dural arteriovenous fistulas: a pilot study. Neuroradiology. 2005;47:10–7.

    Article  Google Scholar 

  5. Li Q, Zhang Q, Huang QH, Fang YB, Zhang ZL, Xu Y, Liu JM. A pivotal role of the vascular endothelial growth factor signaling pathway in the formation of venous hypertension-induced dural arteriovenous fistulas. Mol Med Rep. 2014;9:1551–8.

    Article  CAS  Google Scholar 

  6. Bhogal P, Yeo LL, Henkes H, Krings T, Söderman M. The role of angiogenesis in dural arteriovenous fistulae: the story so far. Interv Neuroradiol. 2018;24:450-4.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cognard C, Gobin YP, Pierot L, Bailly AL, Houdart E, Casasco A, Chiras J, Merland JJ. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology. 1995;194:671–80.

    Article  CAS  Google Scholar 

  8. Borden JA, Wu JK, Shucart WA. A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg. 1995;82:166-79. Erratum in: J Neurosurg. 1995;82:705-6.

    Article  CAS  Google Scholar 

  9. Davies MA, TerBrugge K, Willinsky R, Coyne T, Saleh J, Wallace MC. The validity of classification for the clinical presentation of intracranial dural arteriovenous fistulas. J Neurosurg. 1996;85:830–7.

    Article  CAS  Google Scholar 

  10. VanLandingham M, Fox B, Hoit D, Elijovich L, Arthur AS. Endovascular treatment of intracranial dural arteriovenous fistulas. Neurosurgery. 2014;74 Suppl 1:S42-9.

    Article  Google Scholar 

  11. Liebig T, Henkes H, Brew S, Miloslavski E, Kirsch M, Kühne D. Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment. Neuroradiology. 2005;47:543–51.

    Article  CAS  Google Scholar 

  12. Kirsch M, Liebig T, Kühne D, Henkes H. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients. Neuroradiology. 2009;51:477–83.

    Article  CAS  Google Scholar 

  13. Lekkhong E, Pongpech S, ter Brugge K, Jiarakongmun P, Willinsky R, Geibprasert S, Krings T. Transvenous embolization of intracranial dural arteriovenous shunts through occluded venous segments: experience in 51 Patients. AJNR Am J Neuroradiol. 2011;32:1738–44.

    Article  CAS  Google Scholar 

  14. Albuquerque FC, Ducruet AF, Crowley RW, Bristol RE, Ahmed A, McDougall CG. Transvenous to arterial Onyx embolization. J Neurointerv Surg. 2014;6:281–5.

    Article  Google Scholar 

  15. Lamin S, Chew HS, Chavda S, Thomas A, Piano M, Quilici L, Pero G, Holtmannspolter M, Cronqvist ME, Casasco A, Guimaraens L, Paul L, Gil Garcia A, Aleu A, Chapot R. Embolization of intracranial dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients: a multicenter study. AJNR Am J Neuroradiol. 2017;38:127–31.

    Article  CAS  Google Scholar 

  16. Leyon JJ, Chavda S, Thomas A, Lamin S. Preliminary experience with the liquid embolic material agent PHIL (Precipitating Hydrophobic Injectable Liquid) in treating cranial and spinal dural arteriovenous fistulas: technical note. J Neurointerv Surg. 2016;8:596–602.

    Article  Google Scholar 

  17. Chau Y, Sachet M, Sédat J. Super-selective coil embolization of a basilar perforator artery aneurysm previously treated by the stent-in-stent technique, using an extremely soft bare coil delivered through a one-marker microcatheter. Interv Neuroradiol. 2017;23:492–6.

    Article  Google Scholar 

  18. Beckett JS, Duckwiler GR, Tateshima S, Szeder V, Jahan R, Gonzalez N, Vinuela F. Coil embolization through the marathon microcatheter: advantages and pitfalls. Interv Neuroradiol. 2017;23:28–33.

    Article  Google Scholar 

  19. Horie N, Hayashi K, Morikawa M, Izumo T, Nagata I. A novel method for super-selective coil embolization using an extremely soft bare coil through a liquid embolic delivery microcatheter. Neurol Med Chir (Tokyo). 2015;55:605–9.

    Article  Google Scholar 

  20. Harada K, Morioka J. Initial experience with an extremely soft bare platinum coil, ED coil-10 Extra Soft, for endovascular treatment of cerebral aneurysms. J Neurointerv Surg. 2013;5:577–81.

    Article  Google Scholar 

  21. Miyachi S, Izumi T, Matsubara N, Naito T, Haraguchi KI, Wakabayashi T. The mechanism of catheter kickback in the final stage of coil embolization for aneurysms: the straightening phenomenon. Interv Neuroradiol. 2010;16:353–60.

    Article  CAS  Google Scholar 

  22. Chapot R, Stracke P, Velasco A, Nordmeyer H, Heddier M, Stauder M, Schooss P, Mosimann PJ. The pressure cooker technique for the treatment of brain AVMs. J Neuroradiol. 2014;41:87–91.

    Article  Google Scholar 

  23. Zhang G, Zhu S, Wu P, Xu S, Shi H. The transvenous pressure cooker technique: A treatment for brain arteriovenous malformations. Interv Neuroradiol. 2017;23:194–9.

    Article  Google Scholar 

Download references

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany

    P. Bhogal, M. AlMatter, V. Hellstern, H. Henkes & M. Aguilar Pérez

  2. Neurological Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany

    P. Bhogal & H. Bäzner

  3. Neurosurgical Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany

    O. Ganslandt

  4. Medical Faculty, University Duisburg-Essen, Essen, Germany

    H. Henkes

Authors
  1. P. Bhogal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. AlMatter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Hellstern
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Bäzner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Ganslandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H. Henkes
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Aguilar Pérez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Bhogal.

Ethics declarations

Conflict of interest

P. Bhogal and M. Aguilar Pérez serve as proctors and consultants for phenox. H. Henkes is a co-founder and shareholder of phenox. M. AlMatter, V. Hellstern, H. Bäzner and O. Ganslandt declare that they have no competing interests.

Ethical standards

For this type of retrospective study formal approval is not required.

Additional information

Author Contribution

P. Bhogal, M. AlMatter, V. Hellstern data collection, manuscript preparation; H. Bäzner, O. Ganslandt review, editing, manuscript preparation; H. Henkes study design and concept, review; M. Aguilar Pérez guarantor

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bhogal, P., AlMatter, M., Hellstern, V. et al. High-Grade Dural Arteriovenous Fistulas. Clin Neuroradiol 29, 653–660 (2019). https://doi.org/10.1007/s00062-018-0724-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00062-018-0724-y

Keywords

Search

Navigation