The Application of Copernic RC Balloon in Endovascular Treatment of Complex Intracranial Dural Arteriovenous Fistula of the Transverse Sigmoid Sinus

Background: During endovascular treatment of complex intracranial dural arteriovenous fistulas (DAVFs) of the transverse sigmoid sinus, it can be difficult to preserve the patency of the dural sinus. We have described the details of the transvenous balloon-assisted technique using Copernic RC balloon as a treatment option for patients with complex DAVFs of the transverse sigmoid sinus.

Case description: In these 2 cases, the Copernic RC balloon was navigated into the internal jugular vein and placed at the distal end of the DAVFs in the transverse sinus. After the balloon was fully inflated, a transarterial glue embolization or transvenous Onyx tunnel technique was performed, with complete exclusion of the fistula and patency of the transverse sigmoid sinus. No immediate or delayed postoperative complications occurred.

Conclusion: Transvenous Copernic RC balloon-assisted embolization of DAVFs in the transverse and sigmoid sinuses is safe and can offer complete occlusion of DAVFs and remission of clinical symptoms.