Onyx pulmonary artery embolization after treatment of a low-flow dural arteriovenous fistula: case report.

Abstract

BACKGROUND AND IMPORTANCE:

Endovascular management of dural arteriovenous fistulas (DAVFs) has become an accepted primary and often definitive therapy. We present the first documented case of Onyx pulmonary embolism after embolization of a low-flow DAVF.

CLINICAL PRESENTATION:

A 63-year-old man presented with subarachnoid hemorrhage secondary to a DAVF. Computed tomographic angiography, magnetic resonance imaging, and initial conventional angiogram were negative. A repeat angiogram demonstrated a DAVF, which was cured with Onyx embolization. A routine chest computed tomography after intervention revealed an asymptomatic Onyx embolization cast in a subsegmental pulmonary artery.

CONCLUSION:

Endovascular treatment options include transarterial embolization with microcoils, polyvinyl alcohol particles, n-butyl-2cyanoacrylate, and Onyx (ev3 Neurovascular, Irvine, California). Complications associated with the use of Onyx are low but include embolizate pulmonary embolism. Patients often remain asymptomatic, but for symptomatic patients, conservative treatment options usually result in resolution of symptoms.

• Authors: Bryan A Pukenas, Sudhakar R Satti, Robert Bailey, John B Weigele, Robert W Hurst, Michael F Stiefel
• Journal: Neurosurgery (Neurosurgery) Vol. 68 Issue 5 Pg. E1497-500; discussion E1500 (May 2011) ISSN: 1524-4040 [Electronic] United States
• PMID: 21307786 (Publication Type: Case Reports, Journal Article)

Chemical References

• Drug Combinations
• Onyx 18
• Polyvinyls
• Tantalum

Topics

• Central Nervous System Vascular Malformations (diagnostic imaging, therapy)
• Drug Combinations
• Embolization, Therapeutic (methods)
• Humans
• Male
• Middle Aged
• Polyvinyls
• Pulmonary Artery (diagnostic imaging)
• Radiography
• Tantalum
• Treatment Outcome