Mechanical Extraction of a Refluxed Onyx Piece from the Sigmoid Sinus Using a Solitaire AB Stent for Treating a Dural Arteriovenous Fistula: technical report.

A 49-year-old woman presented with tinnitus since a long time. Magnetic resonance angiography revealed abnormal vessels located around the left sigmoid sinus. Digital subtraction angiography revealed a left sigmoid sinus dural arteriovenous fistula (DAVF) primarily supplied by the left tentorial marginal artery from the left internal carotid artery, posterior meningeal artery from the left vertebral artery, anterior and posterior branches of the left middle meningeal artery, and posterior auricular artery from the left external carotid artery. There was prominent stenosis in the left sigmoid sinus (Figure 1 a-d). The fistula was classified as type II a+b according to the Merland–Cognard classification. Onyx injection was performed through the posterior auricular artery using the combination of a Marathon microcatheter (ev3, Neurovascular, Inc.,