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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
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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.)
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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.)
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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
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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
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J.C. Pryor
eDepartment of Interventional Neuroradiology (J.C.P.), Boston University, Boston, Massachusetts
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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
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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.
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    Table 1:

    Baseline characteristics of study cohort (n = 40 patients with 41 cDAVFs)

    CharacteristicNo. of Patients
    Age (mean; range)57 (30–79)
    Male (%)21 (53%)
    Presentation
        Tinnitus14 (35%)
        Hemorrhage13 (33%)
        Incidental/nonspecific headache syndrome10 (25%)
        Seizure2 (5%)
        Superficial siderosis1 (2%)
    Cognard grade
        I5 (12%)
        IIA3 (7%)
        IIB3 (7%)
        IIA+B4 (10%)
        III15 (37%)
        IV11 (27%)
    Borden grade
        I8 (15%)
        II7 (22%)
        III26 (63%)
    • View popup
    Table 2:

    Procedural characteristics of study cohort (n = 41 DAVFs)

    CharacteristicNo.
    No. of feeding pedicles (mean, range)4 (1–10)
    Total No. of embolization procedures49
    No. of embolization procedures per patient (mean; range)1.2 (1–3)
    No. of single-stage embolizations35 (85%)
    Complications (n = 49 embolization procedures)
        Technical events5 (10%)
        All clinical events7 (14%)
        Transient neurologic1 (2%)
        Permanent neurologic1 (2%)
        Death0
    • View popup
    Table 3:

    Procedural effectiveness at time of treatment, short- and long-term follow-up

    Procedural Effectiveness (No. of patients)Angiographic Cure (No.)
    At end of final treatment (40)35 (95%)
    Short-term angiographic follow-upa (35)33 (94%)
    Long-term angiographic follow-upb (24)24 (100%)
    • ↵a Short-term follow-up occurred at a median of 4.2 months (2–12 months).

    • ↵b Long-term angiographic follow-up occurred at a median of 28.2 months (12–63 months).

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American Journal of Neuroradiology: 35 (9)
American Journal of Neuroradiology
Vol. 35, Issue 9
1 Sep 2014
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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

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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
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