Mechanical Extraction of a Refluxed Onyx Piece from the Sigmoid Sinus Using a Solitaire AB Stent for Treating a Dural Arteriovenous Fistula: technical report

Transarterial embolization of dural arteriovenous fistulas of the lateral sinuses with stent-assisted sinus protection

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.

Mechanical Embolectomy of Distally Migrated Onyx After Surgical Resection of Glomus Vagale Tumor: Technical Report and Review of Literature

BACKGROUND

Endovascular embolization is an important tool in the management of multiple pathologies as a preoperative adjunct in the care of arteriovenous malformations or vascular tumors.

CASE DESCRIPTION

We report a case of delayed distal Onyx migration after surgical resection of a glomus vagale tumor, which had been preoperatively embolized. In this report, the patient underwent successful embolectomy of the migrated Onyx fragment using manual aspiration.

CONCLUSIONS

This case represents the first in the literature to describe this potential delayed complication, as well as its management strategy.