Middle meningeal artery: An effective pathway for achieving complete obliteration following transarterial Ethylene Vinyl Copolymer (Onyx) embolization of dural arteriovenous fistulas
Authors
Akamatsu, YosukeGomez-Paz, Santiago
Tonetti, Daniel A
Vergara-Garcia, David
Moholkar, Viraj M
Kuhn, Anna Luisa
Chida, Kohei
Singh, Jasmeet
de Macedo Rodrigues, Katyucia
Massari, Francesco
Moore, Justin M
Ogilvy, Christopher S
Puri, Ajit S
Thomas, Ajith J
UMass Chan Affiliations
RadiologyDocument Type
Journal ArticlePublication Date
2022-07-07
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Objective: Transarterial Onyx embolization is the mainstay of intracranial non-cavernous dural arteriovenous fistulas (dAVFs) treatment. Although the dural arterial supply varies depending on the location, the impact of arterial access on treatment outcomes has remained unclear. The aim of this study was to characterize factors as sociated with complete obliteration following transarterial Onyx embolization, with a special focus on arterial access routes and dAVF location. Methods: A retrospective analysis of the patients who underwent transarterial Onyx embolization for intracranial dAVFs at two academic institutions was performed. Patients with angiographic follow-up were considered eligible to investigate the impact of the arterial access on achieving complete obliteration. Results: Sixty-eight patients underwent transarterial Onyx embolization of intracranial dAVFs. Complete obliteration was achieved in 65% of all treated patients and in 75% of those with cortical venous reflux. Multivariable analysis identified middle meningeal artery (MMA) access to be a significant independent predictive factor for complete obliteration (OR, 2.32; 95% CI, 1.06-5.06; p=0.034). Subgroup analysis showed that supratentorial and lateral cerebellar convexity dAVFs (OR, 5.72, 95% CI, 1.89-17.33, p=0.002), and Borden type III classification at pre-treatment (OR, 3.13, 95% CI, 1.05- 9.35, p=0.041), were independent predictive factors for complete obliteration following embolization through the MMA. Conclusions: MMA access is an independent predictive factor for complete obliteration following transarterial Onyx embolization for intracranial non-cavernous dAVFs. It is particularly effective for supratentorial and lateral cerebellar convexity dAVFs and those that are Borden type III.Source
Akamatsu Y, Gomez-Paz S, Tonetti DA, Vergara-Garcia D, Moholkar VM, Kuhn AL, Chida K, Singh J, Rodrigues KM, Massari F, Moore JM, Ogilvy CS, Puri AS, Thomas AJ. Middle meningeal artery: An effective pathway for achieving complete obliteration following transarterial Ethylene Vinyl Copolymer (Onyx) embolization of dural arteriovenous fistulas. J Cerebrovasc Endovasc Neurosurg. 2022 Sep;24(3):210-220. doi: 10.7461/jcen.2022.E2021.03.008. Epub 2022 Jul 7. PMID: 35794751; PMCID: PMC9537646.DOI
10.7461/jcen.2022.E2021.03.008Permanent Link to this Item
http://hdl.handle.net/20.500.14038/51268PubMed ID
35794751Rights
Copyright © 2022 by KSCVS and KoNES. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.; Attribution-NonCommercial 4.0 InternationalDistribution License
http://creativecommons.org/licenses/by-nc/4.0/ae974a485f413a2113503eed53cd6c53
10.7461/jcen.2022.E2021.03.008
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Except where otherwise noted, this item's license is described as Copyright © 2022 by KSCVS and KoNES. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.; Attribution-NonCommercial 4.0 International