High-Grade Dural Arteriovenous Fistulas
- 145 Downloads
Dural arteriovenous fistulas (DAVF) are commonly encountered lesions that can be treated both transvenously, transarterially or using a combined approach.
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.
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.
The combination of the Marathon microcatheter and Kaneka ED COIL ∞10 ExtraSoft is useful for the treatment of high grade DAVF.
KeywordsDAVF Coil embolization Transvenous Marathon Kaneka coils
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Compliance with ethical guidelines
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.
For this type of retrospective study formal approval is not required.
- 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.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.CrossRefGoogle Scholar