Use of onyx in the management of tentorial dural arteriovenous fistulae

Abstract

Objective: Tentorial dural arteriovenous fistula (DAVF) is an uncommon disease with a poor natural history. Management of tentorial DAVF remains controversial. This study reports the technique and results of transarterial embolization using Onyx (Micro Therapeutics Inc., Irvine, CA) in the treatment of a series of 14 patients with tentorial DAVFs.

Methods: We retrospectively reviewed the clinical and radiological data of 14 patients with tentorial DAVFs who were treated by transarterial embolization using Onyx at Shanghai Changhai Hospital between 2005 and 2008.

Results: Twelve patients presented with subarachnoid or intraventricular hemorrhage. Complete cure was achieved in 11 patients after 1 procedure and in 1 patient after 2 procedures. Incomplete cure was obtained in the other 2 patients. One patient experienced vessel perforation; another had microcatheter retention. All of the patients recovered well, except 1 patient who died of severe infection caused by ventricular drainage. Clinical follow-up showed no rebleeding or worsening. Follow-up angiography in 8 patients with total occlusion demonstrated no recurrence.

Conclusion: These results suggest that transarterial embolization using Onyx is feasible and effective for the management of tentorial DAVFs.