title: Clinical approach of using Onyx via transarterial access in treating tentorial dural arteriovenous fistula.
abstract: OBJECTIVE
  In this study, based on clinical presentation and angiographic findings, we try to investigate the possibility to do transarterial embolization using Onyx to treat tentorial dural arteriovenous fistula (TDAVF). Particular attention will be given to the relationship between vascular anatomic characteristics and clinical management.
  
  
  METHODS
  We retrospectively reviewed the clinical and radiologic data of 26 patients with TDAVFs, who were treated via transarterial approach using Onyx (including three cases treating with balloon assisting) at our department from January 2005 to April 2010.
  
  
  RESULTS
  The total obliterated rate was 85.7, 53.8, and 66.7% in the tentorial marginal, lateral, and medial subtype, respectively. Symptoms were improved significantly in the patients whose fistulas were totally and sub-totally obliterated. The mean follow-up duration was 2.9 years. After operation, patients' symptom was dramatically improved indicated by the decrease of individual modified Rankin scale (MRS). Only one patient suffered from temporary paralysis of cranial nerve (CN) III. All 26 patients were clinically stable and without any relapsed, increased, or new symptoms. All patients had resumed their normal activities until the latest follow-up.
  
  
  CONCLUSIONS
  Treating the TDAVF via transarterial approach using Onyx maybe a feasible clinical practice. The fistula obliterated rate is highly related to the anatomic characteristic, and high complete obliterated rate can be achieved. Our preliminary results showed that Onyx injection with 'balloon assisting' technique can be helpful in some of the cases.
authors.forename: Chuanghong
authors.initials: C
authors.lastname: Liu
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Donglei
authors.initials: D
authors.lastname: Song
authors.forename: Bing
authors.initials: B
authors.lastname: Leng
authors.forename: Ying
authors.initials: Y
authors.lastname: Mao
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Gu
authors.forename: Yujun
authors.initials: Y
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000628:therapy*; D021721:Balloon Occlusion / Q000379:methods; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004388:Dura Mater / Q000098:blood supply / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; 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
keywords: Dural arteriovenous fistula,; Onyx; Tentorial,