title: Transarterial Onyx Embolization for Patients with Cavernous Sinus Dural Arteriovenous Fistulas Who Have Failed Transvenous Embolization.
abstract: Transvenous embolization is the treatment of choice for cavernous sinus dural arteriovenous fistulas (csDAVFs) despite occasional difficulty in transvenous catheterization. We reported our experience in the treatment of csDAVFs by transarterial Onyx embolization in patients who had failed transvenous catheterization. We reviewed the clinical and radiographic records of csDAVFs patients receiving transarterial Onyx embolization after failed transvenous Onyx embolization at our institution over a period of 31 months. Success was defined as complete or near complete occlusion upon angiographic examination. In seven cases, the microcatheter failed to reach the cavernous sinus; in the remaining case, the internal jugular vein was occlusive. Eight sessions of the embolization and catheterization procedures via the arterial routes were conducted. Among them, five cases via the middle meningeal artery and the other three via the accessory meningeal artery. Angiography, immediately after embolization, revealed complete occlusion in seven cases (87.5 %) and partial occlusion in the remaining case. Angiographic follow-up (range, 6-10 months) showed that all patients achieved complete embolization. In cases where transvenous embolization of the cavernous sinus is difficult, transarterial embolization of the fistulas offers a safe and effective alternative.
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China.|Department of Neurosurgery, the Third Affiliated Hospital, Southern Medical University, 183 Zhongshan Road, Guangzhou, Guangdong, 510630, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China. doctorduan66@163.com.
authors.forename: Chuan-Zhi
authors.initials: CZ
authors.lastname: Duan
authors.affiliation: Department of Neurosurgery, the Third Affiliated Hospital, Southern Medical University, 183 Zhongshan Road, Guangzhou, Guangdong, 510630, China.
authors.forename: Li-Jing
authors.initials: LJ
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China.
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: He
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China.
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Li
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002426:Cavernous Sinus / Q000002:abnormalities / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage; D015641:Radiography, Interventional
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Anastomosis; Artery; Cavernous sinus; Dural arteriovenous fistula; Onyx