使用双球囊压力锅技术对无法置管的经骨供血动脉进行选择性栓塞：技术说明
Selective embolization of an uncatheterizable trans-osseous feeder using a dual-balloon pressure cooker technique: technical note.
文献信息
| PMID | 42758311 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Vishnu Suresh |
| 作者单位 | University of Nebraska Medical Center, Omaha, USA. visuresh@unmc.edu. |
| 期刊 | Neuroradiology |
| SCI 分区 | Q2 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 当由迂曲的经骨枕动脉（OA）供血动脉供血的硬脑膜动静脉瘘（dAVF）无法实现远端置管，且竞争性流出使Onyx从瘘口分流时，其栓塞仍然具有挑战性。我们描述了一种新型双球囊血流隔离技术。
病例描述： 一名79岁女性，患有Cognard IV型横窦dAVF，表现为认知功能下降、头痛和搏动性耳鸣。血管造影显示迂曲的经骨OA供血动脉汇聚于一个瘘口，并伴有皮质静脉反流和静脉瘤。在供血动脉置管失败后，将两根Scepter Mini球囊微导管置于单一OA蒂内。近端和远端血流阻断选择性地隔离了单支供血血管，从而允许用力注射稀释的Onyx。Onyx通过经骨供血动脉，越过瘘口，并填充引流静脉和静脉瘤，实现了完全的血管造影闭塞，且无并发症。
结论： 当远端置管不可行且竞争性流出限制Onyx渗透时，双球囊血流隔离可能有助于实现治愈性栓塞。
英文摘要
BACKGROUND: Embolization of dural arteriovenous fistulas (dAVFs) supplied by tortuous trans-osseous occipital artery (OA) feeders remains challenging when distal catheterization is not achievable and competing runoff diverts Onyx from the fistulous connection. We describe a novel dual-balloon flow-isolation technique.
CASE DESCRIPTION: A 79-year-old woman with a Cognard type IV transverse sinus dAVF presented with cognitive decline, headache, and pulsatile tinnitus. Angiography demonstrated tortuous trans-osseous OA feeders converging on a fistulous connection with cortical venous reflux and a venous varix. Following unsuccessful feeder catheterization, two Scepter Mini balloon microcatheters were positioned within a single OA pedicle. Proximal and distal flow arrest selectively isolated a single feeding vessel, permitting forceful injection of diluted Onyx. Onyx traversed the trans-osseous feeders, crossed the fistulous connection, and filled the draining vein and venous varix, achieving complete angiographic obliteration without complications.
CONCLUSIONS: Dual-balloon flow isolation may facilitate curative embolization when distal catheterization is not feasible and competing runoff limits Onyx penetration.