Objective: To evaluate the efficacy of treatment of dural arteriovenous fistula (DAVF) by transarterial embolization with low dose of N-butyl-2-cyanoacrylate (NBCA).
Methods: Eighteen patients, 6 males and 12 females, aged 47.5 (23-72), with DAVF, 12 with carotid cavernous fistula and 6 with fistula in parietal lobe, underwent transarterial embolization with low dose of NBCA (10%-20%). The key point of transarterial embolization with low dose of NBCA was that low dose NBCA was injected and embolized the veins and then was reversed into the other supplying arteries.
Results: Seventeen patients with DAVF in cavernous region and 6 patients with DAVF in parietal lobe were cured anatomically, with the clinical syndromes disappearing. In 1 patient with DAVF in cavernous region the clinical syndrome were moderately improved after transarterial embolization, however, worsened 2 days later. Cerebrovascular angiography demonstrated that the vein was not completely embolized and the draining vein was broadened, and the clinical syndromes were moderately improved again after carotid artery compression therapy for 10 days.
Conclusion: Convenient and fast, and with low cost and satisfying efficacy, transarterial embolization with low dose of NBCA is a better choice for treatment of DAVF in some cases. The key point of this approach is that the tip of microcatheter is close as much as possible to the fistulae, and NBCA is injected into the fistulae and make the vein diffused well. Attention should be paid to avoid dangerous anastomosis.