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Il Giornale Italiano di Radiologia Medica 2018 Maggio-Giugno;5(3):325-34

DOI: 10.23736/S2283-8376.18.00062-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Endovascular treatment of intracranial dural arteriovenous fistulas using Onyx®: our experience

Fabio BARONE 1 , Giuseppe CRAPARO 2, Maria P. PAPPALARDO 2

1 Istituto di Radiologia, Azienda Ospedaliera Universitaria Policlinico P. Giaccone di Palermo, Palermo, Italia; 2 U.O.C. di Neuroradiologia, ARNAS Civico di Palermo, Palermo, Italia


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BACKGROUND: Dural arteriovenous fistulas (DAVFs) are pathological shunts between meningeal or extracrani-al arteries and the dural venous sinuses, dural veins, or cortical veins. Most of them are cured by arterial or venous embolization, but surgery/radiosurgery can be required in case of failure. Our goal is to evaluate the efficacy of arterial endovascular embolization using Onyx®, a liquid embolizing agent, in selected patients.
METHODS: Thirteen patients with intracranial dural arteriovenous fistulas were included in this study, five of these with cerebral hemorrhage or neurologic deficits related to venous stasis, were treated with transarterial Onyx embolization.
RESULTS: Among these five treated patients, four obtained a complete angiographic cure. In only one patient the complete occlusion of the DAVFs was not achieved and a subsequent surgical treatment was necessary. No com-plications have occurred during the treatments. A good clinical outcome was achieved in all patients treated with complete resolution of neurological symptomatology and no rebleeding occurred during follow-up.
CONCLUSIONS: Based on our experience, we believe that transarterial Onyx embolization may be considered the treatment of choice in appropriately selected patients. Some limitations to the use of this technique are related to the site of the fistulas and its afferent arteries.


KEY WORDS: Central nervous system vascular malformations - Endovascular procedures - Chemoembolization, therapeutic

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