Transvenous embolization of cavernous sinus dural arteriovenous fistulas using detachable coils and Glubran 2 acrylic glue via the inferior petrosal sinus approach

Abstract

Transvenous embolisation via an IPS approach is a highly efficient and safe treatment for CSDAVFs. Embolisation with a combination of coils and acrylic glue may help to achieve complete occlusion of fistulas with fewer coils.

Onyx 18 embolisation of dural arteriovenous fistula via arterial and venous pathways: preliminary experience and evaluation of the short-term outcomes

“…As it requires single-column injection with rapid microcatheter withdrawal, repeated and long duration injection is generally not allowed. Thus this kind of material penetrating into whole fistulous network is limited, resulting in incomplete occlusion [10][11][12]. Onyx 18 has emerged as a non-adhesive, well-penetrating embolic agent, composed of ethylene vinyl alcohol polymer.…”

“…It precipitates as sponge-like clumps and becomes permanent emboli when it reaches the target region [5]. Multiple catheterisations and slow controlled injection are mandatory for total embolisation of DAVF, which is impossible using other adhesive materials in a single setting [12,13].…”

“…In some studies, the inability of NBCA to penetrate freely into all compartments of CS has been documented [10][11][12]. Only 56-81% of csDAVFs were found to be occluded in the initial phase of embolisation using such materials [10,11,19].…”

Treatment of a Urethral Duplication in a Dog Using Cyanoacrylate and Coil Embolization

“…The goal of the coils was not to primarily embolize, but instead to act as a scaffold for the cyanoacrylate. This technique is often employed during glue embolization of vascular anomalies . The use of coil placement to support glue embolization has also been investigated for ureteral occlusion in cases of human urogenital neoplasia …”

The Hemodynamic Changes in Patients with Cerebral Arteriovenous Malformations before and after Interventional Embolization Therapy with Glubran 2 Acrylic Glue

“…Glubran 2 acrylic glue, a new and adhesive embolism material with a distinctive chemical composition, is a co-monomer (N butyl 2 cyanoacrylate and MS owned by GEM Srl) with a high polymerization time and reduced toxicity [9]. Besides, Glubran 2 can close the fistula to avoid the occlusion of venous end expansion, and its polymerization rate can be adjusted in accordance with the size of fistula, blood flow velocity (BFV), and micro catheter position, while the postoperative venous thrombosis ball can absorb, reduce, or even disappear [10, 11]. The goal of CAVM treatment is to eliminate the risk of intracerebral hemorrhages and preserve/maximize the patients’ neurological functions, and interventional treatment should be in accordance with the CAVM architecture, patients’ characteristics and the capabilities of the specific treatment planned for achieving the goals of the treatment [12].…”