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Transarterial Onyx Embolization for Patients with Cavernous Sinus Dural Arteriovenous Fistulas Who Have Failed Transvenous Embolization

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Abstract

Transvenous embolization is the treatment of choice for cavernous sinus dural arteriovenous fistulas (csDAVFs) despite occasional difficulty in transvenous catheterization. We reported our experience in the treatment of csDAVFs by transarterial Onyx embolization in patients who had failed transvenous catheterization. We reviewed the clinical and radiographic records of csDAVFs patients receiving transarterial Onyx embolization after failed transvenous Onyx embolization at our institution over a period of 31 months. Success was defined as complete or near complete occlusion upon angiographic examination. In seven cases, the microcatheter failed to reach the cavernous sinus; in the remaining case, the internal jugular vein was occlusive. Eight sessions of the embolization and catheterization procedures via the arterial routes were conducted. Among them, five cases via the middle meningeal artery and the other three via the accessory meningeal artery. Angiography, immediately after embolization, revealed complete occlusion in seven cases (87.5 %) and partial occlusion in the remaining case. Angiographic follow-up (range, 6–10 months) showed that all patients achieved complete embolization. In cases where transvenous embolization of the cavernous sinus is difficult, transarterial embolization of the fistulas offers a safe and effective alternative.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong, 510282, China

    Jun Wen, Chuan-Zhi Duan, Xin Zhang, Xu-Ying He & Xi-Feng Li

  2. Department of Neurosurgery, the Third Affiliated Hospital, Southern Medical University, 183 Zhongshan Road, Guangzhou, Guangdong, 510630, China

    Jun Wen & Li-Jing Huang

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  1. Jun Wen
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Correspondence to Chuan-Zhi Duan.

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Wen, J., Duan, CZ., Huang, LJ. et al. Transarterial Onyx Embolization for Patients with Cavernous Sinus Dural Arteriovenous Fistulas Who Have Failed Transvenous Embolization. Cell Biochem Biophys 73, 163–169 (2015). https://doi.org/10.1007/s12013-015-0615-7

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