Treatment of dural arteriovenous fistula using ethylene vinyl alcohol (Onyx) arterial embolization as the primary modality: Short-term results

Andrew P. Carlson, Christopher L. Taylor, Howard Yonas

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Object. A dural arteriovenous fistula (DAVF) typically involves meningeal feeding arteries and can cause clinical symptoms ranging from tinnitus to rupture of draining cortical or parenchymal veins. Surgical treatment may be technically demanding. Ethylene vinyl alcohol (Onyx, ev3 Neurovascular) has several properties that make it potentially useful as a primary treatment agent for DAVF. Onyx is expected to be a permanent embolic agent. It should have a decreased risk of catheter retention when compared with other permanent embolic materials. Methods. The authors report a series of six patients with symptomatic DAVF who were treated initially with transarterial Onyx embolization and other endovascular techniques. Results. Five patients had complete occlusion of their DAVF noted on the follow-up angiogram obtained between 2 and 4 months. One patient had residual filling via a small arterial branch that was stable on follow-up angiography. None of the patients had worsening of neurological function. One case was complicated by a retained catheter fragment. Conclusions. Transarterial Onyx embolization and other endovascular methods can angiographically obliterate DAVF. In some cases, embolization allowed occlusion of multiple arterial feeding arteries from a single arterial injection. Technically, the embolization was optimized when a microcatheter position immediately adjacent to the point(s) of fistulization was achieved.

Original languageEnglish (US)
Pages (from-to)1120-1125
Number of pages6
JournalJournal of Neurosurgery
Volume107
Issue number6
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Keywords

  • Arteriovenous fistula
  • Cerebrovascular location
  • Dura mater
  • Embolization
  • Endovascular treatment
  • Onyx

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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