Curative Onyx embolization of tentorial dural arteriovenous fistulas

Ross C. Puffer, David Daniels, David F Kallmes, Harry J. Cloft, Giusepp Lanzino

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Object: The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. Methods: The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization between 2008 and 2011. Information reviewed included clinical presentation, angiographic features, treatment, and clinical and radiologically documented outcome. Clinical follow-up was available in every patient. Radiological follow-up studies were available in 8 of 9 patients (mean follow-up 4.6 months). Results: Six of 9 patients had complete angiographic obliteration (in 5 this was confirmed by a follow-up angiogram obtained 3-6 months later), and 2 patients had near-complete obliteration (faint filling of the venous drainage in the late venous phase). One patient had partial obliteration and required surgical disconnection. In all patients with complete obliteration, transarterial embolization was performed through the posterior branch of the middle meningeal artery. There were no procedural complications, and no morbidity or mortality resulted from Onyx embolization. Conclusions: Transarterial Onyx embolization is a valid, effective, and safe alternative to surgical disconnection in many patients with tentorial DAVFs. The presence of an adequate posterior branch of the middle meningeal artery is critical to achieve a microcatheter position distal enough to increase the likelihood of complete obliteration.

Original languageEnglish (US)
Article numberE4
JournalNeurosurgical Focus
Volume32
Issue number5
DOIs
StatePublished - May 2012

Fingerprint

Central Nervous System Vascular Malformations
Meningeal Arteries
Drainage
Angiography
Morbidity
Mortality

Keywords

  • Embolization
  • Fistula
  • Onyx
  • Tentorial dural arteriovenous fistula

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Curative Onyx embolization of tentorial dural arteriovenous fistulas. / Puffer, Ross C.; Daniels, David; Kallmes, David F; Cloft, Harry J.; Lanzino, Giusepp.

In: Neurosurgical Focus, Vol. 32, No. 5, E4, 05.2012.

Research output: Contribution to journalArticle

Puffer, Ross C. ; Daniels, David ; Kallmes, David F ; Cloft, Harry J. ; Lanzino, Giusepp. / Curative Onyx embolization of tentorial dural arteriovenous fistulas. In: Neurosurgical Focus. 2012 ; Vol. 32, No. 5.
@article{972f3e047b774a24a2b3719ae9f1b895,
title = "Curative Onyx embolization of tentorial dural arteriovenous fistulas",
abstract = "Object: The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. Methods: The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization between 2008 and 2011. Information reviewed included clinical presentation, angiographic features, treatment, and clinical and radiologically documented outcome. Clinical follow-up was available in every patient. Radiological follow-up studies were available in 8 of 9 patients (mean follow-up 4.6 months). Results: Six of 9 patients had complete angiographic obliteration (in 5 this was confirmed by a follow-up angiogram obtained 3-6 months later), and 2 patients had near-complete obliteration (faint filling of the venous drainage in the late venous phase). One patient had partial obliteration and required surgical disconnection. In all patients with complete obliteration, transarterial embolization was performed through the posterior branch of the middle meningeal artery. There were no procedural complications, and no morbidity or mortality resulted from Onyx embolization. Conclusions: Transarterial Onyx embolization is a valid, effective, and safe alternative to surgical disconnection in many patients with tentorial DAVFs. The presence of an adequate posterior branch of the middle meningeal artery is critical to achieve a microcatheter position distal enough to increase the likelihood of complete obliteration.",
keywords = "Embolization, Fistula, Onyx, Tentorial dural arteriovenous fistula",
author = "Puffer, {Ross C.} and David Daniels and Kallmes, {David F} and Cloft, {Harry J.} and Giusepp Lanzino",
year = "2012",
month = "5",
doi = "10.3171/2011.12.FOCUS11323",
language = "English (US)",
volume = "32",
journal = "Neurosurgical Focus",
issn = "1092-0684",
publisher = "American Association of Neurological Surgeons",
number = "5",

}

TY - JOUR

T1 - Curative Onyx embolization of tentorial dural arteriovenous fistulas

AU - Puffer, Ross C.

AU - Daniels, David

AU - Kallmes, David F

AU - Cloft, Harry J.

AU - Lanzino, Giusepp

PY - 2012/5

Y1 - 2012/5

N2 - Object: The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. Methods: The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization between 2008 and 2011. Information reviewed included clinical presentation, angiographic features, treatment, and clinical and radiologically documented outcome. Clinical follow-up was available in every patient. Radiological follow-up studies were available in 8 of 9 patients (mean follow-up 4.6 months). Results: Six of 9 patients had complete angiographic obliteration (in 5 this was confirmed by a follow-up angiogram obtained 3-6 months later), and 2 patients had near-complete obliteration (faint filling of the venous drainage in the late venous phase). One patient had partial obliteration and required surgical disconnection. In all patients with complete obliteration, transarterial embolization was performed through the posterior branch of the middle meningeal artery. There were no procedural complications, and no morbidity or mortality resulted from Onyx embolization. Conclusions: Transarterial Onyx embolization is a valid, effective, and safe alternative to surgical disconnection in many patients with tentorial DAVFs. The presence of an adequate posterior branch of the middle meningeal artery is critical to achieve a microcatheter position distal enough to increase the likelihood of complete obliteration.

AB - Object: The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. Methods: The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization between 2008 and 2011. Information reviewed included clinical presentation, angiographic features, treatment, and clinical and radiologically documented outcome. Clinical follow-up was available in every patient. Radiological follow-up studies were available in 8 of 9 patients (mean follow-up 4.6 months). Results: Six of 9 patients had complete angiographic obliteration (in 5 this was confirmed by a follow-up angiogram obtained 3-6 months later), and 2 patients had near-complete obliteration (faint filling of the venous drainage in the late venous phase). One patient had partial obliteration and required surgical disconnection. In all patients with complete obliteration, transarterial embolization was performed through the posterior branch of the middle meningeal artery. There were no procedural complications, and no morbidity or mortality resulted from Onyx embolization. Conclusions: Transarterial Onyx embolization is a valid, effective, and safe alternative to surgical disconnection in many patients with tentorial DAVFs. The presence of an adequate posterior branch of the middle meningeal artery is critical to achieve a microcatheter position distal enough to increase the likelihood of complete obliteration.

KW - Embolization

KW - Fistula

KW - Onyx

KW - Tentorial dural arteriovenous fistula

UR - http://www.scopus.com/inward/record.url?scp=84861774870&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861774870&partnerID=8YFLogxK

U2 - 10.3171/2011.12.FOCUS11323

DO - 10.3171/2011.12.FOCUS11323

M3 - Article

C2 - 22537130

AN - SCOPUS:84861774870

VL - 32

JO - Neurosurgical Focus

JF - Neurosurgical Focus

SN - 1092-0684

IS - 5

M1 - E4

ER -