A promising adjuvant to detachable coils for cavernous packing: onyx.
Transvenous embolization of cavernous dural arteriovenous fistulae (CDAVFs) with Onyx has recently been reported. This study was undertaken to assess the value of Onyx in transvenous treatment of CDAVFs. We retrospectively reviewed 18 patients who underwent transvenous embolization for CDAVFs of Barrow Type D with detachable coils and Onyx at our institution over five years. Patients were divided into two groups: group A, patients who had been treated with detachable coils; group B, patients who had been treated with a combination of detachable coils and Onyx. The approach routes, angiographic results, complications and clinical outcome were assessed for both groups. Eighteen patients with CDAVFs of Barrow Type D were treated: nine women and nine men; mean age was 41.9 years. Eleven patients treated by 19 procedures of transvenous coiling belonged to group A. Seven patients treated by eight procedures of transvenous Onyx injection belonged to group B. The periprocedural complication rate associated with coiling for both groups was 18.2% vs 16.7% with Onyx. The duration of the procedure in both groups was 6.77-/+2.49 hours vs 3.75-/+1.63 hours with coiling vs Onyx, and the cost of Onyx was cheaper than coils. An excellent outcome was achieved in both groups: 90.9% vs 100% (group A vs group B). Our results associated with both modalities of CDAVFs treatment with clinical outcome show that transvenous embolization with Onyx is a safe alternative to detachable coils in the treatment of CDAVFs. However, more cases need to be evaluated.
Lv
X
X
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University; Beijing, China - ttyyzjb@sina.com.
Jiang
C
C
Li
Y
Y
Wu
Z
Z
Neuroradiology. 2000 Oct;42(10):766-70
11110083
Neurosurgery. 2003 Oct;53(4):836-56; discussion 856-7
14519216
AJNR Am J Neuroradiol. 1997 May;18(5):921-8
9159371
Radiology. 1995 Mar;194(3):705-11
7862966
AJNR Am J Neuroradiol. 2006 Nov-Dec;27(10):2078-82
17110671
Acta Neurochir (Wien). 1999;141(12):1265-71
10672296
AJNR Am J Neuroradiol. 2007 Oct;28(9):1769-70
17885228
Neurosurgery. 1988 Feb;22(2):290-6
3352877
Neuroradiol J. 2007 Dec 31;20(6):718-25
24300008
Neurosurgery. 2005 Mar;56(3):494-502; discussion 494-502
15730574
Neuroradiology. 2001 Jun;43(6):499-502
11465766
Neuroradiol J. 2007 Jun 30;20(3):342-7
24299679
Radiology. 1996 Apr;199(1):209-17
8633147
Neuroradiology. 2004 Dec;46(12):1012-5
15536559
Acta Neurochir (Wien). 1999;141(7):707-9; discussion 709-10
10481781
AJNR Am J Neuroradiol. 2006 Jun-Jul;27(6):1346-9
16775294
Arch Ophthalmol. 1996 Jun;114(6):707-14
8639083
J Neurosurg. 1985 Feb;62(2):248-56
3968564
J Neurosurg. 1999 May;90(5):959-63
10223466
Neuroradiol J. 2007 Jun 30;20(3):348-54
24299680
Neurosurgery. 1997 Jun;40(6):1133-41; discussion 1141-4
9179885
J Neurosurg. 2008 Dec;109(6):1083-90
19035723