Use of onyx in the management of tentorial dural arteriovenous fistulae

Neurosurgery. 2009 Aug;65(2):287-92; discussion 292-3. doi: 10.1227/01.NEU.0000348298.75128.D0.

Abstract

Objective: Tentorial dural arteriovenous fistula (DAVF) is an uncommon disease with a poor natural history. Management of tentorial DAVF remains controversial. This study reports the technique and results of transarterial embolization using Onyx (Micro Therapeutics Inc., Irvine, CA) in the treatment of a series of 14 patients with tentorial DAVFs.

Methods: We retrospectively reviewed the clinical and radiological data of 14 patients with tentorial DAVFs who were treated by transarterial embolization using Onyx at Shanghai Changhai Hospital between 2005 and 2008.

Results: Twelve patients presented with subarachnoid or intraventricular hemorrhage. Complete cure was achieved in 11 patients after 1 procedure and in 1 patient after 2 procedures. Incomplete cure was obtained in the other 2 patients. One patient experienced vessel perforation; another had microcatheter retention. All of the patients recovered well, except 1 patient who died of severe infection caused by ventricular drainage. Clinical follow-up showed no rebleeding or worsening. Follow-up angiography in 8 patients with total occlusion demonstrated no recurrence.

Conclusion: These results suggest that transarterial embolization using Onyx is feasible and effective for the management of tentorial DAVFs.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / methods
  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Central Nervous System Vascular Malformations / pathology
  • Central Nervous System Vascular Malformations / therapy*
  • Cerebral Angiography
  • Cerebral Arteries / abnormalities*
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / pathology
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / pathology
  • Cerebral Hemorrhage / therapy
  • Cerebral Veins / abnormalities*
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / pathology
  • Dimethyl Sulfoxide / administration & dosage*
  • Dimethyl Sulfoxide / adverse effects
  • Dura Mater / blood supply*
  • Dura Mater / diagnostic imaging
  • Dura Mater / pathology
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Embolization, Therapeutic / mortality
  • Fatal Outcome
  • Female
  • Humans
  • Injections, Intra-Arterial / adverse effects
  • Injections, Intra-Arterial / methods
  • Male
  • Middle Aged
  • Polyvinyls / administration & dosage*
  • Polyvinyls / adverse effects
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Onyx copolymer
  • Polyvinyls
  • Dimethyl Sulfoxide