Transarterial Onyx packing of the transverse–sigmoid sinus for dural arteriovenous fistulas

Objective: To report transarterial Onyx packing of the transverse–sigmoid sinus for dural arteriovenous fistulae (DAVFs). Methods: We retrospectively studied consecutive 5 patients (2 female and 3 male) treated for a transverse–sigmoid sinus DAVF since 2008 in whom transverse sinus packing was attempted with a transarterial approach Onyx embolization. The mean clinical follow-up period was 6.2 months. Results: Of the five lesions, 2 fistulas were type IIa, 3 were type IIb, according to the Cognard classification. Five Onyx embolizations were all performed via the middle meningeal artery. Cure was obtained in all cases after completion of direct sinus packing. No complications were revealed. Conclusions: Transarterial Onyx packing of transverse–sigmoid sinus for DAVFs via the meningeal arterial system is a safe therapeutic alternative in selected cases.