Direct transforaminal Onyx embolization of intracranial dural arteriovenous fistulas: technical note and report of five cases.

Intracranial dural arteriovenous fistulas with retrograde leptomeningeal or cortical drainage are considered aggressive. Conventional treatment in these cases is possible surgically or with endovascular arterial injections of Onyx or cyanoacrylate, but there are still some cases where distal navigation is not possible due to tortuosity of the arterial feeders. We present five cases of direct transforaminal Onyx embolization where endovascular distal navigation could not be achieved.