No shinkei geka. Neurological surgery · 2026
[Devices and Techniques for Transarterial Embolization of Dural Arteriovenous Fistulas: Current Trends in the Use of Liquid Embolic Agents and Microcatheters].
СтатьяОбзорАннотация на английскомНазвание и аннотация: Перевод в очереди
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Akioka Naoki
Аннотация
Transarterial embolization (TAE) of dural arteriovenous fistulas (DAVFs) has evolved significantly following insurance approval of liquid embolic agents such as OnyxTM and Histoacryl® (n-butyl-2-cyanoacrylate[NBCA]). Onyx allows prolonged injection and controlled penetration into the venous side, whereas NBCA offers rapid polymerization and thrombogenicity. The success of TAE depends on the selection of appropriate delivery devices. The ultra-fine microcatheter, DeFrictor® nano, provides superior distal access to small feeders near the shunt point, thereby facilitating effective embolization. In cases where the affected sinus serves as a normal venous drainage route, sinus protection balloon-assisted TAE is useful for achieving both shunt occlusion and preservation of venous function. This technique allows retrograde embolization of multiple feeders through the venous side. Understanding the characteristics of various liquid embolic agents and specialized devices is essential for achieving complete cure and preventing recurrence. This review discusses the latest devices and effective strategies for TAE of DAVFs.