The Treatment Outcome of Transarterial Embolization for Isolated Sinus Type Dural Arteriovenous Fistula between NBCA and Onyx

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  • Imai Tasuku
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Izumi Takashi
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Matsubara Noriaki
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Nishihori Masahiro
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Ito Masashi
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Sato Masaki
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Tamari Yosuke
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Ishida Mamoru
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Tsukada Tetsuya
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan
  • Miyachi Shigeru
    Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan
  • Wakabayashi Toshihiko
    Department of Neurosurgery, Nagoya University, Nagoya, Aichi, Japan

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<p>Objective: The purpose of this study was to compare the clinical outcome of transarterial embolization for isolated sinus type dural arteriovenous fistula (iDAVF) using n-butyl-cyanoacrylate (NBCA) and Onyx.</p><p>Methods: Seventeen lesions of iDAVF in 17 patients who underwent transarterial embolization between March 2008 and February 2015 were retrospectively analyzed. They were treated by embolization using NBCA in 10 patients, Onyx in 5 patients, and combination of NBCA and Onyx in 2 patients. We compared the results between embolization with NBCA and Onyx as follows: complete occlusion rate, number of embolized vessels, procedure-related complications, treatment time, dose of radiation exposure, amount of contrast agent, and total cost of the devices.</p><p>Results: The complete occlusion rate of iDAVF was significantly higher in the Onyx group: 4 of 10 (40%) in NBCA and 5 of 5 (100%) in Onyx (P = 0.04). The number of treated vessels (5.1 ± 1.2 in NBCA, 1 in Onyx [P <0.001]), the maximum skin entrance dose (NBCA: 5030 ± 1646 [mGy], Onyx: 1670 ± 564 [mGy] in Onyx [P <0.01]), and total cost of the devices (601,265 ± 15,749 [yen] in NBCA, 374,210 ± 122,142 [yen] in Onyx [P <0.01]) were significantly higher in the NBCA. No significant difference was observed in the treatment time and contrast agent dose.</p><p>Conclusion: In transarterial embolization of iDAVF, a higher complete occlusion rate was obtained with Onyx, which was also advantageous for reducing the exposure dose and cost of the devices.</p>

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