Use of onyx in the management of tentorial dural arteriovenous fistulae.
OBJECTIVE
Tentorial dural arteriovenous fistula (DAVF) is an uncommon disease with a poor natural history. Management of tentorial DAVF remains controversial. This study reports the technique and results of transarterial embolization using Onyx (Micro Therapeutics Inc., Irvine, CA) in the treatment of a series of 14 patients with tentorial DAVFs.


METHODS
We retrospectively reviewed the clinical and radiological data of 14 patients with tentorial DAVFs who were treated by transarterial embolization using Onyx at Shanghai Changhai Hospital between 2005 and 2008.


RESULTS
Twelve patients presented with subarachnoid or intraventricular hemorrhage. Complete cure was achieved in 11 patients after 1 procedure and in 1 patient after 2 procedures. Incomplete cure was obtained in the other 2 patients. One patient experienced vessel perforation; another had microcatheter retention. All of the patients recovered well, except 1 patient who died of severe infection caused by ventricular drainage. Clinical follow-up showed no rebleeding or worsening. Follow-up angiography in 8 patients with total occlusion demonstrated no recurrence.


CONCLUSIONS
These results suggest that transarterial embolization using Onyx is feasible and effective for the management of tentorial DAVFs.
Huang
Qinghai
Q
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xu
Yi
Y
Hong
Bo
B
Li
Qiang
Q
Zhao
Wenyuan
W
Liu
Jianmin
J
D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002550:Cerebral Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage* / Q000009:adverse effects; D004388:Dura Mater / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide