Treatment Of Tentorial Dual Arteriovenous Fistula With Onyx Via Transarterial Access In 26 Cases

Objective:To explore the clinical therapeutic experience of a series of tentorial dural arteriovenous fistulas (DAVFs) treated by transarterial embolization with Onyx-18 and the role of assisting balloon played in embolization.Methods:26 patients with tentorial DAVFs were sequentially treated between January 2005 and July 2009. All patients were treated transarterial access with Onyx-18 in succession and 3 of them were-treated with the help of assisting balloon. The clinical presentation, radiological, treatment strategies and results were studied.Results:17 patients experienced clinical and angiographic cure without any complication in following-up, including 3 patients treated with the help of assisting balloon. Another 9 patients achieved incompletely obliteration; symptoms were completely resolved and got a good therapeutic effect in following-up. In 7 cases with tentorial marginal type TDAVF,6 cases were experienced angiographic cure.7 of 13 cases with tentorial lateral type TDAVF experienced angiographic cure.4 of 6 cases with tentorial median type TDAVF experienced angiographic cure. All 17 cases who experienced angiographic cure had MRS 0 when discharge. In 9 cases who experienced incomplete angiographic cure,7 had MRS 1,2 had MRS 2 when discharge. All patients were followed for a mean duration of 2.4 years (range,9 month to 4.3 years). All 26 patients were clinical stability, and no clinical symptoms of relapse, increased or new symptoms appear; I n 17 patients who underwent follow-up DSA demonstrated no recurrence.Conclusion:It is an effective method that treat tentorial arteriovenous fistula with onyx via transarterial access, and assisting balloon can play an important role in endovascular procedure if necessary.