Preliminary Experience with Onyx Embolization for the Treatment of Intracranial Dural Arteriovenous Fistulas

Nogueira, Raul G; Dabus, Guilherme; Rabinov, James D.; Eskey, Clifford J.; Ogilvy, C; Hirsch, Joshua A; Pryor, Johnny C.

doi:10.3174/ajnr.a0768

Cited by 172 publications

(138 citation statements)

References 12 publications

(17 reference statements)

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“…About 5% of complications after transvenous embolization have been reported 10 . They included worsening diplopia 11-14 , facial pain 11 , transient visual loss 15 , retrograde arterial penetration of embolic agents 16 , embolic infarction 15 , posterior fossa haemorrhage and venous infarction 4 .…”

Section: Discussionmentioning

confidence: 99%

Transvenous Embolization of a Carotid Cavernous Fistula Complicated by a Hematoma at the Tentorial Edge

et al. 2014

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Indirect (dural) carotid cavernous fistulae are generally treated by endovascular surgery primary transvenous embolization that is safe and effective. We describe here a case of a left indirect carotid cavernous fistula that presented with proptosis and eye redness. The patient underwent transvenous embolization of carotid cavernous sinus. The procedure was complicated by a haemorrhage from the cavernous sinus. The post procedural CT scan showed a haematoma at the tentorial edge. Precise diagnosis and prompt treatment could prevent severe complications.

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Section: Discussionmentioning

confidence: 99%

Transvenous Embolization of a Carotid Cavernous Fistula Complicated by a Hematoma at the Tentorial Edge

et al. 2014

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“…[1][2][3][4] We have previously reported our short-term experience using Onyx in these patients 5 and have compared the success of this technique with embolization using n-butyl cyanoacrylate. 6 However, there currently remain no published data on the longterm effectiveness for embolization of cDAVFs by using Onyx, to our knowledge.…”

mentioning

confidence: 99%

Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up

Chandra

Leslie‐Mazwi²,

Mehta³

et al. 2014

American Journal of Neuroradiology

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“…Recently, ethylene vinyl alcohol (Onyx) has been used to treat high-grade fistulas with some success [10][11][12][13][14] . We report our single centre experience with arterial Onyx embolisation for the treatment of DAVFs with direct cortical venous drainage.…”

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confidence: 99%

Arterial Onyx Embolisation of Intracranial DAVFs with Cortical Venous Drainage

Chew

Weill

Guilbert

et al. 2009

Can. j. neurol. sci.

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Intracranial dural arteriovenous fistulas (DAVFs) are lesions with a heterogeneous clinical course, related to the varying patterns of venous drainage. Dural arteriovenous fistulas without cortical venous involvement tend to be relatively benign in course, while lesions with cortical venous drainage (whether direct or via reflux from dural venous sinuses) are more aggressive, having a higher rate of clinical presentation with aggressive neurological symptoms and intracranial haemorr-ABSTRACT: Purpose: To present our experience with the endovascular management of intracranial dural arteriovenous fistulas with direct cortical venous drainage by trans-arterial embolisation using Onyx. Materials & Methods: Between January 2004 and April 2008, 12 consecutive high grade intracranial dural arteriovenous fistulas (Cognard type III (eight patients) or IV (three patients)) were treated by trans-arterial embolisation with Onyx. The majority of cases were treated by Onyx embolisation alone. One case had additional embolisation with n-butyl-2-cyanoacrylate at the same session. Imaging follow-up was obtained in all but one patient (mean 3.6 months). Results: Nine patients had a technical success at the end of the embolisation procedure with complete angiographic exclusion of the fistula. Two patients had a small residual fistula at the end of embolisation, one of which had residual mild cortical venous drainage. Both were stable at follow-up angiography. One patient had a residual fistula supplied by the ophthalmic artery, which was thought to be unsafe to embolise and was sent for surgery, which was curative. In one patient the microcatheter ruptured, with a fragment of the distal microcatheter left in the occipital artery. No clinical complications were observed in this series at clinical follow-up (mean 3.3 months). Two patients were noted to have significant radiation dose. Conclusion: Endovascular management of intracranial dural arteriovenous fistulas with direct venous cortical drainage by trans-arterial Onyx embolisation is a safe and effective treatment according to our experience. Fluoroscopy times and radiation dose may be a concern. Chez un patient une embolisation additionnelle de n-butyl-2-cyanoacrylate (nBCA) a été effectuée au cours de la même session. Une imagerie a été obtenue chez tous les patients sauf un au cours du suivi (moyenne de 3,6 mois). Résultats : Nous avons obtenu un succès technique chez neuf patients à la fin de l'embolisation, avec exclusion angiographique complète de la fistule. Deux patients avaient une petite fistule résiduelle à la fin de l'embolisation, dont un présentait un léger drainage veineux cortical résiduel. Ces deux patients étaient stables à l'angiographie de suivi. Un patient avait une fistule résiduelle nourrie par l'artère ophtalmique dont l'embolisation a été jugée trop risquée. Il a été référé en chirurgie et l'intervention a été un succès. Chez un patient, le microcathéter s'est rompu et un fragment distal du microcathéter s'est logé dans l'artère occipitale. Il a été lai...

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Preliminary Experience with Onyx Embolization for the Treatment of Intracranial Dural Arteriovenous Fistulas

Abstract: BACKGROUND AND PURPOSE:Onyx was recently approved for the treatment of pial arteriovenous malformations, but its use to treat dural arteriovenous fistulas (DAVFs) is not yet well established. We now report on the treatment of intracranial DAVFs using this nonadhesive liquid embolic agent.

Cited by 172 publications

References 12 publications

Transvenous Embolization of a Carotid Cavernous Fistula Complicated by a Hematoma at the Tentorial Edge

Transvenous Embolization of a Carotid Cavernous Fistula Complicated by a Hematoma at the Tentorial Edge

Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up

Arterial Onyx Embolisation of Intracranial DAVFs with Cortical Venous Drainage

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