Results and complications of transarterial embolization of intracranial dural arteriovenous fistulas using Onyx-18
- 1 December 2008
- journal article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 109 (6), 1083-1090
- https://doi.org/10.3171/jns.2008.109.12.1083
Abstract
Use of the Onyx liquid embolic system has become an option for treating dural arteriovenous fistulas (DAVFs) because of its advantageous nonadhesive and cohesive properties. However, the complication rates associated with the use of this system have not been reported. The authors present their initial experience of the risks related to transarterial embolization using this system. Between February 2005 and February 2007, 31 patients with DAVFs were treated at Beijing Tiantan Hospital. Transarterial embolization using Onyx-18 was performed as a preoperative adjunct or as definitive therapy. The demographic characteristics, angiographic features, clinical presentation, treatment, and outcome of the patients were reviewed. Clinical follow-up status was supplemented by telephone interviews to determine Glasgow Outcome Scale scores. In 19 patients (61.3%) there was complete angiographic evidence of elimination of the shunts and resolution of the symptoms. The remaining 12 patients were treated successfully but did not attain complete embolization and had residual shunting. Adverse events occurred in 5 of 31 patients, with 3 DAVFs located at the tentorium, 1 at the inferior petrosal sinus, and 1 at the cavernous sinus. Complications included trigeminocardiac reflex in 2 patients (6.5%), hemifacial hypesthesia in 3 patients (9.7%), hemifacial palsy in 2 patients (6.5%), jaw pain in 1 patient (3.2%), posterior fossa infarction in 1 patient (3.2%), and microcatheter gluing in 1 patient (3.2%). At the last follow-up examination, all patients had returned to an independent clinical status. Although a complete resolution of symptoms can be achieved with transarterial embolization using the Onyx liquid embolic system, the potential for serious complications exists with this procedure, necessitating the participation of a skilled neurointerventionalist.Keywords
This publication has 52 references indexed in Scilit:
- CLINICORADIOLOGICAL REVIEWNeurosurgery, 2007
- Transcranial embolization of a transverse-sigmoid sinus dural arteriovenous fistula carried out through a decompressive craniectomyActa Neurochirurgica, 2006
- Tentorial dural arteriovenous malformation manifesting as trigeminal neuralgia treated by stereotactic radiosurgery: a case reportSurgical Neurology, 2006
- Do leptomeningeal venous drainage and dysplastic venous dilation predict hemorrhage in dural arteriovenous fistula?Surgical Neurology, 2006
- Tentorial dural arteriovenous fistula presenting symptoms due to mass effect on the dilated draining vein: case reportSurgical Neurology, 2006
- The falcine trigeminocardiac reflex: case report and review of the literatureSurgical Neurology, 2005
- Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approachSurgical Neurology, 2004
- Surgical management of an unruptured dural arteriovenous fistula of the anterior cranial fossa: natural history for 7 yearsSurgical Neurology, 2004
- Postsurgical Development of Dural Arteriovenous Malformations after Transpetrosal and Transtentorial OperationsNeurosurgery, 1995
- ASSESSMENT OF OUTCOME AFTER SEVERE BRAIN DAMAGE A Practical ScaleThe Lancet, 1975