Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas with Cortical Venous Drainage: New Management Using Onyx

Cognard, Christophe; Januel, Anne Christine; Silva, N.A.; Tall, Philippe

doi:10.3174/ajnr.a0817

Cited by 320 publications

(245 citation statements)

References 25 publications

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“…Immediate postembolization or short-term DSA cure rates range from 62% to 92%. [1][2][3][4] Angiographic follow-up varied per series, with a median of 3-6 months. In 2 large cohort series, the short-term DSA occlusion rate was 100%.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…[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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“…1 Recent articles have demonstrated that the endovascular technique by using Onyx has some advantages over cyanoacrylate, including the following: greater control of the embolic agent during injection, injection time, and overall high cure rates with few complications. [2][3][4][5][6] In contrast to DAVFs with direct cortical venous drainage and reflux into cortical veins, fistulas with direct drainage into the venous sinuses are often treated with a transvenous approach, particularly for lateral or cavernous sinus DAVFs. 7,8 The cavernous DAVFs rarely have favorable arterial access, but the fistulas located in the lateral sinus often have arterial pedicles amenable to selective catheterization and adequate injection of Onyx.…”

mentioning

confidence: 99%

The Use of Onyx in Different Types of Intracranial Dural Arteriovenous Fistula

Abud

Nguyen

Saint-Maurice

et al. 2011

AJNR Am J Neuroradiol

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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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Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas with Cortical Venous Drainage: New Management Using Onyx

Cited by 320 publications

References 25 publications

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

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

The Use of Onyx in Different Types of Intracranial Dural Arteriovenous Fistula

Arterial Onyx Embolisation of Intracranial DAVFs with Cortical Venous Drainage

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