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AJNR - American Journal of Neuroradiology

Published ahead of print on January 8, 2009
doi: 10.3174/ajnr.A1419

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American Journal of Neuroradiology 30:462-468, March 2009
© 2009 American Society of Neuroradiology

INTERVENTIONAL

Complications Related to Percutaneous Transarterial Embolization of Intracranial Dural Arteriovenous Fistulas in 40 Patients

X. Lv^a, C. Jiang^a, J. Zhang^a, Y. Li^a and Z. Wu^a

^a From the Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China

Please address correspondence to Chuhan Jiang, MD, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China, 6, Tiantan Xili, Beijing, 100050 Hebei, China; e-mail: ttyyzjb{at}sina.com

BACKGROUND AND PURPOSE: An increasing number of intracranial dural arteriovenous fistulas (DAVFs) are amenable to endovascular treatment with Onyx. However, reports on complications caused by this technique have been limited. We present the initial Beijing Tiantan Hospital experience with adverse events related to transarterial Onyx embolization for DAVFs.

MATERIALS AND METHODS: Between September 2005 and February 2008, a total of 40 patients with DAVFs were treated at our institute with Onyx-18. There were 11 women and 29 men with a mean age of 43.15 years (age range, 23–60 years). We reviewed the clinical presentation, angiographic features, treatment, and outcome.

RESULTS: In 40 patients, total obliteration was achieved in 25 DAVFs (62.5%), with the remaining 15 patients not cured with residual shunts. Complications occurred in 9 patients, 5 DAVFs were located at tentorium, 2 were located at the transverse-sigmoid sinus, 1 was found at the inferior petrosal sinus, and 1 was found at the cavernous sinus, leading to permanent disability in 3 patients (morbidity, 7.5%). Complications included reflexive bradyarrhythmia in 3 (7.5%) patients, hemifacial hypoesthesia in 3 (7.5%) patients, hemifacial palsy in 2 (5%) patients, posterior fossa infarction in 2 (5%) patients, jaw pain in 1 (2.5%) patient, microcatheter gluing in 1 (2.5%) patient, hallucinations in 1 (2.5%) patient, and Onyx migration in 1 (2.5%) patient.

CONCLUSION: Although complete cure can be achieved by transarterial embolization with Onyx, the potential for serious complications exists with this procedure.