Balloon-Assisted Embolization of Brain Arteriovenous Malformations with a Low-Profile Dual Lumen

Introduction: The “balloon assisted technique” (BAT) is an alternative to the “pressure cooker technique,” using a dual lumen balloon (DLB) and consisting in injecting the liquid embolic agent through the working lumen of the DLB while balloon inflated.

Method(s): Consecutive patients treated from July 2020 to July 2021 in 3 tertiary centers using the BAT with low-profile dual lumen balloons (Scepter Mini, Microvention, Tustin, CA) for the endovascular treatment of bAVMs were retrospectively reviewed. Patients’ demographics were collected as well as bAVMs angio-architectural features. Feasibility of DLB navigation close to the nidus was evaluated. Technical as well as clinical (ischemic and/or hemorrhagic) complications were also systematically assessed.

Result(s): Three patients (16%) had procedure-related ischemic stroke and 2 patients (10.5%) had a late hemorrhage. None of these complications led to severe permanent sequela. Complete occlusion of bAVM embolized with intention to cure was recorded in 11/13 cases (84.6%).

Conclusion(s): The BAT using low-profile dual lumen balloons is feasible and seems safe for embolization of bAVMs. It may help to reach high occlusion rate, when performed with intention to cure.

Publication History

Article published online:
09 February 2023