Ear necrosis resulting from the endovascular onyx-18 embolization of a dural arteriovenous fistula fed by the posterior auricular artery.
OBJECTIVE
The treatment of a dural arteriovenous fistula (DAVF) can involve surgery, radiosurgery, or endovascular embolization. New embolization techniques and agents have expanded the role of endovascular treatment.


METHODS
We report the endovascular embolization with Onyx-18 of a DAVF fed by the posterior auricular artery.


RESULTS
The DAVF was successfully embolized; however, the patient's ear developed ischemic necrosis of the superolateral pinna.


CONCLUSIONS
Onyx-18 can provide high rates of success in the treatment of DAVFs in well-selected patients. Risks of end organ ischemia must be considered during endovascular embolization and when counseling patients regarding procedural risk.
Jankowitz
Brian T
BT
Department of Neurosurgery, Minimally Invasive EndoNeurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Vora
Nirav
N
Jovin
Tudor
T
Horowitz
Michael
M
D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D004423:Ear / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009336:Necrosis; D016896:Treatment Outcome; D055815:Young Adult