Staged transarterial endovascular embolization of a malignant dural arteriovenous fistula using Onyx and n-butyl cyanoacrylate.

Abstract

Dural arteriovenous fistulae (dAVFs) are vascular anomalies formed by abnormal connections between branches of dural arteries and dural veins or dural venous sinus(es). These pathologic shunts constitute 10%-15% of all intracranial arteriovenous malformations. The hallmark of malignant dAVFs is the presence of cortical venous drainage, a finding that increases the likelihood of nonhemorrhagic neurologic deficit, intracranial hemorrhage, and mortality if left unaddressed. Endovascular approaches have become the primary modality for the treatment of dAVFs. The authors present a case of staged endovascular transarterial embolization of a malignant dAVF running parallel to the left transverse sinus in a patient with headaches and pulsatile tinnitus. The fistula was completely treated using Onyx and n-butyl cyanoacrylate.The video can be found here: https://youtu.be/GSAto_wlC3I.

• Authors: Silvia Gesheva, William T Couldwell, Vance Mortimer, Philipp Taussky, Ramesh Grandhi
• Journal: Neurosurgical focus (Neurosurg Focus) Vol. 46 Issue Suppl_2 Pg. V1 (Apr 01 2019) ISSN: 1092-0684 [Electronic] United States
• PMID: 30939434 (Publication Type: Journal Article)

Chemical References

• Cyanoacrylates
• Enbucrilate
• Dimethyl Sulfoxide

Topics

• Aged
• Central Nervous System Vascular Malformations (pathology, therapy)
• Cerebral Angiography (methods)
• Cyanoacrylates (pharmacology)
• Dimethyl Sulfoxide (pharmacology)
• Embolization, Therapeutic
• Enbucrilate (pharmacology)
• Endovascular Procedures
• Female
• Humans
• Intracranial Arteriovenous Malformations (diagnosis, therapy)
• Male
• Middle Aged