Complications related to percutaneous transarterial embolization of intracranial dural arteriovenous fistulas in 40 patients.
OBJECTIVE
An increasing number of intracranial dural arteriovenous fistulas (DAVFs) are amenable to endovascular treatment with Onyx. However, reports on complications caused by this technique have been limited. We present the initial Beijing Tiantan Hospital experience with adverse events related to transarterial Onyx embolization for DAVFs.


METHODS
Between September 2005 and February 2008, a total of 40 patients with DAVFs were treated at our institute with Onyx-18. There were 11 women and 29 men with a mean age of 43.15 years (age range, 23-60 years). We reviewed the clinical presentation, angiographic features, treatment, and outcome.


RESULTS
In 40 patients, total obliteration was achieved in 25 DAVFs (62.5%), with the remaining 15 patients not cured with residual shunts. Complications occurred in 9 patients, 5 DAVFs were located at tentorium, 2 were located at the transverse-sigmoid sinus, 1 was found at the inferior petrosal sinus, and 1 was found at the cavernous sinus, leading to permanent disability in 3 patients (morbidity, 7.5%). Complications included reflexive bradyarrhythmia in 3 (7.5%) patients, hemifacial hypoesthesia in 3 (7.5%) patients, hemifacial palsy in 2 (5%) patients, posterior fossa infarction in 2 (5%) patients, jaw pain in 1 (2.5%) patient, microcatheter gluing in 1 (2.5%) patient, hallucinations in 1 (2.5%) patient, and Onyx migration in 1 (2.5%) patient.


CONCLUSIONS
Although complete cure can be achieved by transarterial embolization with Onyx, the potential for serious complications exists with this procedure.
Lv
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Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Jiang
C
C
Zhang
J
J
Li
Y
Y
Wu
Z
Z
D000328:Adult; D001919:Bradycardia / Q000209:etiology; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology*; D006212:Hallucinations / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D061221:Trigeminal Nerve Injuries; D055815:Young Adult