Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
Research ArticleInterventional

Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up

R.V. Chandra, T.M. Leslie-Mazwi, B.P. Mehta, A.J. Yoo, J.D. Rabinov, J.C. Pryor, J.A. Hirsch and R.G. Nogueira
American Journal of Neuroradiology September 2014, 35 (9) 1793-1797; DOI: https://doi.org/10.3174/ajnr.A3938
R.V. Chandra
aFrom the Neuroradiology and Neurovascular Surgery Services, Departments of Diagnostic Imaging and Surgery (R.V.C.), Monash University, Melbourne, Victoria, Australia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T.M. Leslie-Mazwi
bNeuroendovascular Service (T.M.L.-M., B.P.M., A.J.Y., J.D.R., J.A.H.)
cDepartment of Neurology (T.M.L.-M., B.P.M.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B.P. Mehta
bNeuroendovascular Service (T.M.L.-M., B.P.M., A.J.Y., J.D.R., J.A.H.)
cDepartment of Neurology (T.M.L.-M., B.P.M.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A.J. Yoo
bNeuroendovascular Service (T.M.L.-M., B.P.M., A.J.Y., J.D.R., J.A.H.)
dDepartment of Radiology (A.J.Y., J.D.R., J.A.H.), Division of Diagnostic Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.D. Rabinov
bNeuroendovascular Service (T.M.L.-M., B.P.M., A.J.Y., J.D.R., J.A.H.)
dDepartment of Radiology (A.J.Y., J.D.R., J.A.H.), Division of Diagnostic Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.C. Pryor
eDepartment of Interventional Neuroradiology (J.C.P.), Boston University, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.A. Hirsch
bNeuroendovascular Service (T.M.L.-M., B.P.M., A.J.Y., J.D.R., J.A.H.)
dDepartment of Radiology (A.J.Y., J.D.R., J.A.H.), Division of Diagnostic Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
R.G. Nogueira
fNeuroendovascular and Neurocritical Care Services and Neurology, Neurosurgery, and Radiology (R.G.N.), Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, Georgia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • References
  • PDF
Loading

Abstract

BACKGROUND AND PURPOSE: Endovascular therapy with liquid embolic agents is a common treatment strategy for cranial dural arteriovenous fistulas. This study evaluated the long-term effectiveness of transarterial Onyx as the single embolic agent for curative embolization of noncavernous cranial dural arteriovenous fistulas.

MATERIALS AND METHODS: We performed a retrospective review of 40 consecutive patients with 41 cranial dural arteriovenous fistulas treated between March 2006 and June 2012 by using transarterial Onyx embolization with intent to cure. The mean age was 57 years; one-third presented with intracranial hemorrhage. Most (85%) had cortical venous drainage. Once angiographic cure was achieved, long-term treatment effectiveness was assessed with DSA and clinical follow-up.

RESULTS: Forty-nine embolization sessions were performed; 85% of cranial dural arteriovenous fistulas were treated in a single session. The immediate angiographic cure rate was 95%. The permanent neurologic complication rate was 2% (mild facial palsy). Thirty-five of the 38 patients with initial cure underwent short-term follow-up DSA (median, 4 months). The short-term recurrence rate was only 6% (2/35). All patients with occlusion at short-term DSA undergoing long-term DSA (median, 28 months) had durable occlusion. No patient with long-term clinical follow-up (total, 117 patient-years; median, 45 months) experienced hemorrhage.

CONCLUSIONS: Transarterial embolization with Onyx as the single embolic agent results in durable long-term cure of noncavernous cranial dural arteriovenous fistulas. Recurrence rates are low on short-term follow-up, and all patients with angiographic occlusion on short-term DSA follow-up have experienced a durable long-term cure. Thus, angiographic cure should be defined at short-term follow-up angiography instead of at the end of the final embolization session. Finally, long-term DSA follow-up may not be necessary if occlusion is demonstrated on short-term angiographic follow-up.

ABBREVIATIONS:

cDAVF
cranial dural arteriovenous fistula
CVD
cortical venous drainage
  • © 2014 by American Journal of Neuroradiology
View Full Text
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 35 (9)
American Journal of Neuroradiology
Vol. 35, Issue 9
1 Sep 2014
  • Table of Contents
  • Index by author
  • Complete Issue (PDF)
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up
R.V. Chandra, T.M. Leslie-Mazwi, B.P. Mehta, A.J. Yoo, J.D. Rabinov, J.C. Pryor, J.A. Hirsch, R.G. Nogueira
American Journal of Neuroradiology Sep 2014, 35 (9) 1793-1797; DOI: 10.3174/ajnr.A3938

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up
R.V. Chandra, T.M. Leslie-Mazwi, B.P. Mehta, A.J. Yoo, J.D. Rabinov, J.C. Pryor, J.A. Hirsch, R.G. Nogueira
American Journal of Neuroradiology Sep 2014, 35 (9) 1793-1797; DOI: 10.3174/ajnr.A3938
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • ABBREVIATIONS:
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • The Influence of Angioarchitectural Features on the Success of Endovascular Embolization of Cranial Dural Arteriovenous Fistulas with Onyx
  • Beam hardening artifacts of liquid embolic agents: comparison between Squid and Onyx
  • Outcome of transarterial treatment of dural arteriovenous fistulas with direct or indirect cortical venous drainage
  • Incompletely obliterated cranial arteriovenous fistulae are safely and effectively treated with adjuvant {varepsilon}-aminocaproic acid
  • Preliminary experience with the liquid embolic material agent PHIL (Precipitating Hydrophobic Injectable Liquid) in treating cranial and spinal dural arteriovenous fistulas: technical note
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Flow Diversion for ICA Aneurysms with Compressive Neuro-Ophthalmologic Symptoms: Predictors of Morbidity, Mortality, and Incomplete Aneurysm Occlusion
  • The Safety and Efficacy of Flow Diversion versus Conventional Endovascular Treatment for Intracranial Aneurysms: A Meta-analysis of Real-world Cohort Studies from the Past 10 Years
  • ADC Level is Related to DWI Reversal in Patients Undergoing Mechanical Thrombectomy: A Retrospective Cohort Study
Show more INTERVENTIONAL

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2021 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2022 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire