Embolization of cranial dural arteriovenous fistulae with ONYX: Indications, techniques, and outcomes

Rashmi Saraf; Manish Shrivastava; Nishant Kumar; Uday Limaye

doi:10.4103/0971-3026.59748

Indian Journal of Radiology and Imaging, Table of Contents

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2010; 20(01): 26-33
DOI: 10.4103/0971-3026.59748

Interventional Radiology

Embolization of cranial dural arteriovenous fistulae with ONYX: Indications, techniques, and outcomes

Rashmi Saraf

Division of Interventional Neuroradiology, Department of Radiology, KEM Hospital, Mumbai, India

,

Manish Shrivastava

Division of Interventional Neuroradiology, Department of Radiology, KEM Hospital, Mumbai, India

,

Nishant Kumar

Division of Interventional Neuroradiology, Department of Radiology, KEM Hospital, Mumbai, India

,

Uday Limaye

Division of Interventional Neuroradiology, Department of Radiology, KEM Hospital, Mumbai, India

› Author Affiliations

Abstract

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Abstract

Objectives: The purpose of this study was to establish the role of the liquid embolic agent, ONYX, in the treatment of cranial dural arteriovenous fistulae (DAVFs) and to redefine the indications, techniques and outcomes of treatment with ONYX. Materials and Methods: This is a retrospective study of 25 DAVF patients who underwent endovascular treatment with ONYX between February 2006 and July 2008. All patients of DAVF presenting in this period were treated with ONYX. Results: Anatomic cure (i.e., complete angiographic closure of the fistula) was achieved in a single session and through a single arterial pedicle injection in 21 out of 25 patients (cure rate of 84%). Out of four patients with residual fistulae, one achieved cure that was evident on a control angiogram obtained at 3 months while three had no vascular access for further embolization and so were referred for radiosurgery. There was only one recurrence seen in angiograms obtained at the end of one year and this patient was re-embolized successfully with ONYX. Complications were seen in two patients. Conclusion: ONYX embolization of DAVFs has revolutionized the endovascular treatment of DAVFs, achieving high cure rates in a single session with minimal complications. Transarterial ONYX embolization should be the first option for all locations, except cavernous DAVFs.

Keywords

Dural arteriovenous fi stula - embolization - ONYX - technique

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References

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