Dural arteriovenous fistulas with direct cortical venous drainage treated with Onyx: a case series.
Dural arteriovenous fistulas (DAVFs) may have aggressive symptoms, especially if there is direct cortical venous drainage. We report our preliminary experience in transarterial embolization of DAVFs with direct cortical venous drainage (CVR) using Onyx.


METHODS
Nine patients with DAVFs with direct cortical venous drainage were treated: eight type IV and one type III (Cognard). Treatment consisted of transarterial embolization using Onyx-18. Immediate post treatment angiographies, clinical outcome and late follow-up angiographies were studied.


RESULTS
Complete occlusion of the fistula was achieved in all patients with only one procedure and injection in only one arterial pedicle. On follow-up, eight patients became free from symptoms, one improved and no one deteriorated. Late angiographies showed no evidence of recurrent DAVF.


CONCLUSIONS
We recommend that transarterial Onyx embolization of DAVFs with direct cortical venous drainage be considered as a treatment option, while it showed to be feasible, safe and effective.
Trivelato
Felipe Padovani
FP
Division of Interventional Neuroradiology, Department of Neurosurgery, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Abud
Daniel Giansante
DG
Ulhôa
Alexandre Cordeiro
AC
Menezes
Tiago de Jesus
Tde J
Abud
Thiago Giansante
TG
Nakiri
Guilherme Seikem
GS
Colli
Benedicto Oscar
BO
Gusmão
Sebastião Nataniel Silva
SN
Rezende
Marco Túlio Salles
MT
D000328:Adult; D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004322:Drainage / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D016896:Treatment Outcome
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide