Transvenous treatment of cavernous dural arteriovenous fistulae with onyx and coils

We report on patients with cavernous dural arteriovenous fistulae (CDAVFs) who underwent transvenous embolization via different transvenous approaches with Onyx and coils. Twelve patients presenting with clinically symptomatic CDAVFs who were treated between August 2005 and November 2007 at Beijing Tiantan Hospital were reviewed. The approach routes, angiographic results and clinical outcome were assessed. Retrospective analysis of data for 12 patients (age range 36-75 yrs, mean age 59.3 yrs) with CDAVFs was performed. The CDAVFs were treated with Onyx and coils via different transvenous approaches in 14 procedures. Cerebral angiography was performed to confirm the treatment and diagnosis. The mean clinical follow-up period was 5.5 months. A total of 13 transvenous procedures and one transarterial procedure were performed for 12 CDAVFs. Eleven patients with CDAVFs of the CS were cured with respect to clinical symptoms, and one patient experienced improvement. The approach via the internal jugular vein and inferior petrosal sinus (n=10) was possible, with complete occlusion of the fistula in all cases. With the approach via the facial vein (n=2), there was a good success rate. We encountered no complications in any of the cases. Transvenous treatment of CDAVFs with Onyx and coils can be an effective option for different transvenous approaches.