Document Detail


Transarterial embolization of intracranial dural arteriovenous fistulas with direct cortical venous drainage using ethylene vinyl alcohol copolymer (Onyx).
MedLine Citation:
PMID:  19636502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This communication concerns the new possibilities and technical aspects of using ethylene vinyl alcohol copolymer (Onyx, EVAC) for endovascular treatment of intracranial dural arteriovenous fistulas with direct cortical venous drainage (DAVF-CVs). PATIENTS AND METHODS: Five patients with symptomatic DAVF-CVs were treated primarily with transarterial embolization using Onyx. RESULTS: All patients had complete obliteration of their DAVFs with a single Onyx injection that resulted in passage of embolic agent to the draining vein. One asymptomatic technical adverse event occurred (a broken microcatheter on retrieval). On clinical follow-up (mean 12.6 months, range 1-27 months), two patients with intracranial hemorrhage and one patient with cerebellar symptoms improved significantly after treatment, with residual symptoms that did not affect independence. One patient had remission of tinnitus and headache but developed seizures, and one patient was asymptomatic. Imaging follow-up (mean 4 months, range 1-7 months) did not show any revascularization. CONCLUSION: Embolization with Onyx represents a significant improvement in the endovascular treatment of DAVF-CVs. Cases that would not be effectively treated with cyanoacrylate or particles can be cured by embolization alone.
Authors:
Sandro Rossitti
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-08
Journal Detail:
Title:  Klinische Neuroradiologie     Volume:  19     ISSN:  1615-6706     ISO Abbreviation:  Klin Neuroradiol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422582     Medline TA:  Klin Neuroradiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  122-8     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University Hospital, Linköping, Sweden. sandro.rossitti@lio.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Edema / etiology,  therapy
Central Nervous System Vascular Malformations / drug therapy,  radiography,  therapy*
Cerebral Angiography
Cerebral Arteries / radiography
Cerebral Cortex / blood supply,  radiography
Cerebral Veins / radiography
Dimethyl Sulfoxide*
Drainage / methods*
Embolization, Therapeutic* / adverse effects
Female
Humans
Male
Middle Aged
Polyvinyls*
Chemical
Reg. No./Substance:
0/Onyx copolymer; 0/Polyvinyls; 67-68-5/Dimethyl Sulfoxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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