Feasibility, safety, and efficacy of endovascular treatment of anterior cranial fossa dural arteriovenous fistulas: a systematic review and meta-analysis with a subanalysis for Onyx

Ferreira, Marcio Yuri; Gunkan, Ahmet; Batista, Savio; Porto, Mauricio; Camerotte, Raphael; de Barros Oliveira, Leonardo; Porto Junior, Silvio; Okoye, Obiora; da Fonseca, Igor Oliveira; Bertani, Raphael; Tanus Machado, Elias Antonio; Ferreira, Christian; Langer, David; Ciccio, Gabriele; Serulle, Yafell

doi:10.1007/s10143-024-02446-5

Neurosurg Rev

2024

DOI: 10.1007/s10143-024-02446-5

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Feasibility, safety, and efficacy of endovascular treatment of anterior cranial fossa dural arteriovenous fistulas: a systematic review and meta-analysis with a subanalysis for Onyx

Marcio Yuri Ferreira,

Ahmet Gunkan,

Savio Batista

et al.

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Cited by 2 publications

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Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis

Günkan,

Ferreira,

Vilardo

et al. 2024

Interv Neuroradiol

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Background A wide range of liquid embolic agents has been used in endovascular treatment (EVT) of dural arteriovenous fistulas (dAVFs) and cerebral arteriovenous malformations (cAVMs). Newer liquid embolics, Squid (Balt) and PHIL (MicroVention), aim to improve the safety and efficacy of EVT of dAVFs and cAVMs. Objective To assess the safety and efficacy of EVT of cAVMs and dAVFs using Squid or PHIL as an embolic agent. Methods We searched major databases following PRISMA guidelines and included studies with less than fivepatients reporting on EVT of dAVFs and/or cAVMs using Squid or PHIL as embolic agent. We analyzed efficacy outcomes including complete occlusion, incomplete occlusion, and recurrence at follow up, and safety outcomes including procedure-related complications, morbidity, and mortality with a random-effects meta-analysis. Separate analyses were performed for cAVMs and dAVFs. Subanalyses were conducted for studies exclusively utilizing PHIL and those exclusively utilizing Squid, for both cAVMs and dAVFs. Results Ten studies, comprising 214 patients (53.7% male), were found. Of these, 113 patients had 113 dAVFs, while 101 patients had 101 cAVMs. Complete occlusion rates following embolization were 91% for dAVFs and 32% for cAVMs. A subanalysis of dAVFs embolized solely with Squid and PHIL identified 93% and 86% complete occlusion rates, respectively. The overall procedure-related permanent morbidity rate was 3% for dAVFs and 7% for cAVMs. There was only one procedure-related mortality, which developed in a cAVM case, across 214 cases. Conclusion Squid and PHIL are safe and effective embolic agents for treatment of dAVFs and cAVMs.

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Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis

Günkan,

Ferreira,

Vilardo

et al. 2024

Interv Neuroradiol

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Posterior short ciliary arteries ischemia following embolization of anterior ethmoid artery to treat dural arteriovenous fistulas: a case report

Han,

Liu,

Yao

et al. 2024

BMC Ophthalmol

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Background The Onyx™ Liquid Embolic System is a non-adhesive liquid embolic agent, which has been proved by the US FDA for embolization of lesions in the peripheral and neurovasculature since 2005. We reported a case of ischemic optic neuropathy after using Onyx-18 to embolize the anterior ethmoid arteries that feeding dural arteriovenous fistulas (DAVF). Case presentation A 57-year-old Asian male presented with anterior cranial fossa DAVF underwent embolotherapy by delivering Onyx-18 through a microcatheter into the anterior ethmoid arteries under angiography guidance. The interventional procedure was successful and no clear evidence was found pointing to untargeted occlusive embolus. But after the surgery the patient experienced delayed painless vision loss in the right eye (RE). The fundoscopy showed unilateral papilledema with pale optic disc in RE, accompanied by significant edema and thickening in the retinal nerve fiber layer (RNFL) of macula. The fundus fluorescence angiography showed that most of the optic disc in RE had postponed or absent fluorescence filling. Visual evoked potential (VEP) confirmed that the amplitude of the P100 component was decreased in RE without significant prolongation of the latency. The patient was diagnosed with anterior ischemic optic neuropathy, but immediate pulse steroid therapy failed to rescue his vision. Conclusion Preoperative evaluation of the patient’s hemodynamic status and fundus examination are essential for assessing the risk of ischemic ocular complications, and the non-adhesive liquid embolic agent Onyx-18 should be used cautiously during endovascular embolization of intracranial artery.

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Feasibility, safety, and efficacy of endovascular treatment of anterior cranial fossa dural arteriovenous fistulas: a systematic review and meta-analysis with a subanalysis for Onyx

Cited by 2 publications

References 32 publications

Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis

Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis

Posterior short ciliary arteries ischemia following embolization of anterior ethmoid artery to treat dural arteriovenous fistulas: a case report

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