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Abstract Details

Onyx© Embolization of Dural Arteriovenous Fistulae at the Cranio-Cervical Junction
Cerebrovascular Disease and Interventional Neurology
P8 - Poster Session 8 (11:45 AM-12:45 PM)
6-024

To report two cases of CRC fistula treated successfully with endovascular embolization with Onyx©. 
Dural arteriovenous fistula (dAVF) are rare vascular malformations; a rare subset of this group are dAVFs located at the cranio-cervical junction. Subarachnoid hemorrhage (SAH) is one of the possible neurological complications of cranio-cervical (CRC) fistula rupture. Treatment options include radiosurgery, endovascular embolization and/or open surgery. The use of liquid embolic agent is a reasonable option for endovascular treatment.
A single institution retrospective case report identified two case of cranio-cervical junction (CRC) fistulae that were treated successfully with Onyx© embolization.
Two patients were identified to have cranio-cervical junction DAVF in which one patient presented with SAH, and the 2nd patient presented with bulbar symptoms due to rapidly worsening edema in the brainstem. Both fistulas were supplied from the vertebral artery; one at the level of Dural ring of the vertebral artery and the other at the jugular foramen level which was also supplied by ascending pharyngeal artery. Onyx© embolization was the treatment of choice in both cases. The Onyx© embolization resulted in 80% reduction of the fistula nidus in the first case, and complete occlusion of the fistula in the second and the third case. The 6 months follow-up revealed complete occlusion of both fistulas with complete neurological recovery 

This case series suggests that the treatment of CRC fistulae with Onyx© embolization is efficacious with good clinical outcomes. 


 

Authors/Disclosures
Khaled Gharaibeh, MD (ProMedica Neurosciences Center)
PRESENTER 		Dr. Gharaibeh has nothing to disclose.
Mustafa Al-Chalabi, DO Dr. Al-Chalabi has nothing to disclose.
Marion Oliver, MD (GRMEP) Dr. Oliver has nothing to disclose.
Mouhammad A. Jumaa, MD (ProMedica Stroke Network) Dr. Jumaa has nothing to disclose.