Related Experiment Video
Updated: Jan 4, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Onyx Embolization of Spinal Arteriovenous Fistula via Scepter Balloon
Jonathon Lebovitz1, Christopher Storey1, Ahmad Sweid1
1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
Background:
Spinal arteriovenous fistulas (AVFs) are a rare entity that can have devastating neurologic outcomes. Currently, these lesions are treated via open microsurgical resection or transarterial embolization with good success. However, some patients cannot be treated with a minimally invasive endovascular technique secondary to difficulty catheterizing their vascular anatomy. Our aim is to present a case of balloon-assisted Onyx embolization of a spinal AVF.
Case Description:
We present the case of a 59-year-old male with progressive lower back pain with lower-extremity weakness. We performed a spinal angiogram where an AVF was identified with very torturous anatomy. The patient was originally treated with open microsurgical resection; however, ≈6 weeks later the fistula and symptoms returned. At that time, we were able to treat the lesion with the Scepter-C balloon.
Conclusions:
We present a challenging case in which normal embolization microcatheters were unable to navigate difficult anatomy, but we were able to gain access and obliterate the fistula by using a balloon catheter.
