title: Dural arteriovenous fistulas with direct cortical venous drainage treated with Onyx: a case series.
abstract: 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.
authors: Division of Interventional Neuroradiology, Department of Neurosurgery, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors: Felipe Padovani
authors: FP
authors: Trivelato
authors: Daniel Giansante
authors: DG
authors: Abud
authors: Alexandre Cordeiro
authors: AC
authors: Ulhôa
authors: Tiago de Jesus
authors: Tde J
authors: Menezes
authors: Thiago Giansante
authors: TG
authors: Abud
authors: Guilherme Seikem
authors: GS
authors: Nakiri
authors: Benedicto Oscar
authors: BO
authors: Colli
authors: Sebastião Nataniel Silva
authors: SN
authors: Gusmão
authors: Marco Túlio Salles
authors: MT
authors: Rezende
mesh_terms: 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
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide