Endovascular treatment of intracranial XXXX with cortical venous drainage: new management using Onyx.

@entity1 @entity129 @entity455 @entity548 @entity1416 @entity2457 @entity292 @entity715 @entity1211 @entity50
BACKGROUND AND PURPOSE: @entity2457 ( @entity2457 ) represent one of the most dangerous types of intracranial AV shunts. Most of them are cured by @entity455 , but surgery/radiosurgery can be required in case of failure. Our goal was to reconsider the endovascular treatment strategy according to the new possibilities of @entity1416 using non polymerizing liquid embolic agent. MATERIALS AND METHODS: Thirty @entity1 were included in a prospective study during the interval between July 2003 and November 2006. Ten of these had type II, 8 had type III, and 12 had type IV @entity292 . Sixteen presented with @entity548 . Five had been treated previously with other embolic materials. RESULTS: Complete angiographic cure was obtained in 24 cases. Of these 24 cures, 20 were achieved after a single procedure. Cures were achieved in 23 of 25 @entity1 who had not been embolized previously and in only 1 of 5 previously embolized @entity1 . Among these 24 @entity1 , 23 underwent a follow-up angiography, which has confirmed the complete cure. Partial occlusion was obtained in 6 @entity1 , 2 were cured after additional surgery, and 2 underwent radiosurgery. Onyx volume injected per procedure ranged from 0.5 to 12.2 mL (mean, 2.45 mL). Rebleeding occurred in 1 completely cured @entity1 at day 2 due to draining vein @entity715 . One @entity1 had @entity129 that resolved. Two ethmoidal @entity2457 were occluded. All 10 of the @entity1 with @entity50 and then CVR drainage were cured. CONCLUSION: Based on this experience, we believe that Onyx may be the treatment of choice for many @entity1 with intracranial @entity2457 (ICDAVF) with direct cortical @entity1211 (CVR). The applicability of this new embolic agent indicates the need for reconsideration of the global treatment strategy for such @entity292 .
