title: Ear necrosis resulting from the endovascular onyx-18 embolization of a dural arteriovenous fistula fed by the posterior auricular artery.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Minimally Invasive EndoNeurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Jankowitz
authors.forename: Nirav
authors.initials: N
authors.lastname: Vora
authors.forename: Tudor
authors.initials: T
authors.lastname: Jovin
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
mesh_terms: 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