Selective embolization of an uncatheterizable trans-osseous feeder using a dual-balloon pressure cooker technique: technical note

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....

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No actionable change for audiologists; this is a highly specialized neuroradiology technique relevant to vascular surgeons and interventional neuroradiologists, not to hearing care practitioners.

Dural arteriovenous fistulas (abnormal blood vessel tangles near the brain lining) can cause pulsatile tinnitus and hearing changes, so advances in their embolization (blocking blood flow) techniques may occasionally benefit patients referred from audiology.

1. 01Technical note in Neuroradiology (2026) describing a dual-balloon pressure cooker embolization method.
2. 02Targets dural arteriovenous fistulas (abnormal vessel connections near the brain lining) with difficult-to-reach feeders from the occipital artery.
3. 03Technique addresses cases where conventional catheter navigation fails due to vessel tortuosity.
4. 04Audience is interventional neuroradiologists, not audiologists or hearing care professionals.
5. 05No outcome data reported beyond procedural description; evidence level is case-series at best.

PMID

42758311

DOI

10.1007/s00234-026-04194-3.

Journal

Neuroradiology

Publication type

case_report

Evidence level

4

Population

Patients with dural arteriovenous fistulas featuring tortuous trans-osseous occipital artery feeders resistant to conventional catheterization

Intervention

Dual-balloon pressure cooker embolization technique for trans-osseous arteriovenous fistula feeders