Embolization of the dural arteriovenous fistulas by using Onyx and detachable coils via a venous access

Abstract

Background Simple embolization of supplying artery of dural arteriovenous fistula (DAVF) is usually alleviative treatment. New supplying arteries may appear after embolization of proximal supplying artery of vascular nests and venous draining may be changed, thus the risk of hemorrhage will be increased. The most effective method of interventional therapy for DAVFs is embolization of draining veins, and the success rate will be highest via a venous access. This article aims to explore the method and therapeutic results of interventional therapy of DAVF by using Onyx glue and detachable coils via a venous access. Methods A total of 12 patients with DAVFs were treated with transvenous embolization, among whom 8 involved the cavernous sinus and 4 were in transverse-sigmoid sinus. After embolization, angiography and follow-up study were applied to evaluate the clinical efficacies. Results Immediate postoperative digital subtraction angiography (DSA) indicated that the fistulas were completely occluded in 11 cases and blood flow velocity in fistulas slowed down evidently in 1 case. The 3-36 months follow-up study found that clinical symptoms disappeared in 11 cases and relieved evidently in 1 case. Conclusion Interventional embolization by using Onyx and detachable coils via a venous access is an effective and safe treatment method for DAVFs.