Nedeljkovic Zarko, Vukasinovic Ivan, Petrovic Masa, Nedeljkovic Aleksandra, Nastasovic Tijana, Bascarevic Vladimir, Micovic Mirko, Milicevic Mihailo, Milic Marina, Jovanovic Nemanja, Stanimirovic Aleksandar, Scepanovic Vuk, Grujicic Danica
Clinic for Neurosurgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Center for Radiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
J Clin Med. 2024 Oct 2;13(19):5899. doi: 10.3390/jcm13195899.
Endovascular embolization is an effective treatment option for cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (DAVFs). The objective of this study was to assess the safety and efficacy of Menox in patients with cranial dural arteriovenous fistulas. : From January 2021 to January 2023, 19 patients with intracranial DAVFs underwent embolization procedures. All patients were treated by embolization with Menox or/and in combination with other embolization products such as Onyx (Covidien, Irvine, California), PHIL (MicroVention, Tustin, California), and Squid (Balt Extrusion, Montmorency, France). Treatment approaches were selected depending on the anatomical location of the fistula. Patients were monitored and followed-up for 12 months. : The patients' mean age was 56.26 ± 16.49 years. Of these 19 patients, 58% ( = 11) were treated with the Menox liquid embolizing agent (LEA) alone or in combination with different LEAs, while = 7 were treated with other LEAs and 1 patient was treated solely with coils. Complete occlusion of DAVFs with Menox and other agents was evident in 68.4% ( = 13/19) of patients. Complete occlusion (100%) was observed in the sinus rectus, transverse sinus, and diploic veins of the orbital roof, while complete occlusion was observed in 50% of falcotentorial patients and 60% of superior sagittal sinus patients. The lowest rate of complete fistula obliteration was observed in the dural carotid cavernous fistula (CCF) group (25%). An intra-procedural adverse event occurred in one patient. No other post-procedural adverse events were noted. Furthermore, in patients treated with Menox, total occlusion was achieved in 72.7% ( = 8) of patients, whereas the non-Menox group had 62.5% ( = 5) of patients with 100% occlusion and 37.5% ( = 3) of patients with subtotal occlusion. : Outcomes using Menox alone and in combination with other agents were effective, and it is safe for the treatment of dural arteriovenous fistulas.
血管内栓塞术是治疗脑动静脉畸形（AVM）和硬脑膜动静脉瘘（DAVF）的一种有效治疗选择。本研究的目的是评估Menox治疗颅内硬脑膜动静脉瘘患者的安全性和有效性。：2021年1月至2023年1月，19例颅内DAVF患者接受了栓塞手术。所有患者均采用Menox栓塞治疗或/和联合其他栓塞产品，如Onyx（科维迪恩公司，加利福尼亚州欧文市）、PHIL（微介入公司，加利福尼亚州图斯廷市）和Squid（巴尔挤压公司，法国蒙特莫朗西）。根据瘘管的解剖位置选择治疗方法。对患者进行了12个月的监测和随访。：患者的平均年龄为56.26±16.49岁。在这19例患者中，58%（n = 11）单独使用Menox液体栓塞剂（LEA）或与不同的LEA联合治疗，而n = 7例患者使用其他LEA治疗，1例患者仅使用弹簧圈治疗。68.4%（n = 13/19）的患者使用Menox和其他药物实现了DAVF的完全闭塞。在直窦、横窦和眶顶板障静脉中观察到完全闭塞（100%），而在小脑幕患者中有50%观察到完全闭塞，在上矢状窦患者中有60%观察到完全闭塞。在硬脑膜颈动脉海绵窦瘘（CCF）组中观察到完全瘘管闭塞率最低（25%）。1例患者发生术中不良事件。未发现其他术后不良事件。此外，在使用Menox治疗的患者中，72.7%（n = 8）的患者实现了完全闭塞，而非Menox组中100%闭塞的患者占62.5%（n = 5），部分闭塞的患者占37.5%（n = 3）。：单独使用Menox以及与其他药物联合使用的效果良好，治疗硬脑膜动静脉瘘是安全的。
