Mid and long term outcomes of dural arteriovenous fistula endovascular management with Onyx. Experience of a single tertiary center

Abstract

Early evidence has indicated that endovascular Onyx embolization is safe and effective at achieving an initial angiographic cure. Results of our series suggest that angiographic and clinical outcomes of Onyx embolization remain relatively stable at mid and long term follow-up.

Intraventricular hemorrhage after dural fistula embolization

“…Maimon et al describe a morbidity of 6% (1/17 patients) related to a transient trochlear nerve palsy and on a retrospective studied by Rangel-Castilla et al, the authors describe a complication rate of 9.7% (7 of 72 patients), of which only one corresponded to a intraparenchymal hemorrhage. 5,6 After a systematic review of the international literature using the PubMed database, we were not able to find any article describing the occurrence of an IVH after DAVF embolization, which corroborates the relevance of this report.…”

“…3 In reality DAVF embolization with Onyx ® , a nonadhesive embolic agent composed by ethylene-vinyl alcohol dissolved in dimethyl-sulfoxide, has grown to become one of the major approaches to DAVF, which is intimately linked to its remarkable cure rates and low morbidity. 3,5,6 In fact, there are not many complications reported after these techniques. Maimon et al describe a morbidity of 6% (1/17 patients) related to a transient trochlear nerve palsy and on a retrospective studied by Rangel-Castilla et al, the authors describe a complication rate of 9.7% (7 of 72 patients), of which only one corresponded to a intraparenchymal hemorrhage.…”

“…5 The incidence of these complications is even higher for DAVF who have cortical venous drainage, 6 practicable. 3 In reality DAVF embolization with Onyx ® , a nonadhesive embolic agent composed by ethylene-vinyl alcohol dissolved in dimethyl-sulfoxide, has grown to become one of the major approaches to DAVF, which is intimately linked to its remarkable cure rates and low morbidity.…”

Evolution of treatment and a detailed analysis of occlusion, recurrence, and clinical outcomes in an endovascular library of 260 dural arteriovenous fistulas

“…2,[25][26][27][28] We chose the term "initial angiographic occlusion" rather than "cure" to refer to dAVFs occluded after initial treatment. We reserve the term "cure" to refer specifically to dAVFs with radiographic evidence of persistent vein/fistula casting and persistent angiographic occlusion at least 4 months after treatment on formal complete angiographic evaluation.…”

Mid- and long-term outcomes of carotid-cavernous fistula endovascular management with Onyx and n-BCA: experience of a single tertiary center

“…Ethylene vinyl alcohol copolymer (Onyx; ev3 Neurovascular, Irvine, California, USA) was approved by the Food and Drug Administration (FDA) in 2005 for the embolization of cerebral arteriovenous malformations and its applications have since expanded to include CCFs, dural arteriovenous fistulas, and other intracranial vascular pathologies 15 16. Early results of CCF embolization with both Onyx and n-butyl cyanoacrylate (n-BCA glue; Cordis Neurovascular, Miami, Florida, USA) have shown excellent obliteration success and relatively low complication rates, but the long-term outcomes and frequency of fistula recanalization in such cases are largely unknown 10 15 17 18.…”