Dual-Lumen Balloon Catheter Technique for Onyx Embolization of Spinal Dural Arteriovenous Fistula

Spinal dural arteriovenous fistula (SDAVF) is the most common type of spinal vascular malformation. The
main purpose of endovascular treatment is to occlude the fistula site and the proximal part of the draining
vein. However, this is not always possible because of the difficulty of selective catheterization in patients
with tortuous feeding arteries, as well as the risk of reflux of the liquid embolic agent. Herein, we present
three cases in which a dual-lumen balloon catheter together with a liquid embolic agent was used to
occlude the SDAVF. Complete and persistent occlusion was confirmed by magnetic resonance images
taken at 6 months after the treatment. Using the dual-lumen balloon catheter technique in cases of long and
tortuous feeder arteries supplying the SDAVF can result in safe and successful embolization