Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, February 25, 2021

Onyx embolization for dural arteriovenous fistulas: a multi-institutional study

I thought gluing was not done for brain work. Ask your doctor for guarantees on its use.
FDA issues warning about Covidien brain device that has killed nine - Onyx glue

 

Onyx embolization for dural arteriovenous fistulas: a multi-institutional study

  1. Yangchun Li1,
  2. Stephanie H Chen2,
  3. Ridhima Guniganti3,
  4. Akash P Kansagra4,
  5. Jay F Piccirillo4,
  6. Ching-Jen Chen5,
  7. Thomas Buell6,
  8. Jason P Sheehan7,
  9. Dale Ding8,
  10. Giuseppe Lanzino9,
  11. Waleed Brinjikji10,
  12. Louis J Kim11,
  13. Michael R Levitt12,
  14. Isaac Josh Abecassis13,
  15. Diederik O Bulters14,
  16. Andrew Durnford15,
  17. W Christopher Fox16,
  18. Adam J Polifka17,
  19. Bradley A. Gross18,
  20. Samir Sur1,
  21. David J McCarthy18,
  22. Dileep R Yavagal19,
  23. Eric C Peterson20,
  24. Minako Hayakawa21,
  25. Colin Derdeyn22,
  26. Edgar A Samaniego23,
  27. Sepideh Amin-Hanjani24,
  28. Ali Alaraj25,
  29. Amanda Kwasnicki26,
  30. Fady T Charbel25,
  31. J Marc C van Dijk27,
  32. Adriaan RE Potgieser28,
  33. Junichiro Satomi29,
  34. Yoshiteru Tada30,
  35. Adib Abla31,
  36. Ryan Phelps32,
  37. Rose Du33,
  38. Pui Man Rosalind Lai33,
  39. Gregory J Zipfel34,34,
  40. Robert M Starke1,35
  41. On behalf of the Consortium for Dural Arteriovenous Fistula Outcomes Research

Author affiliations

Abstract

Background Although the liquid embolic agent, Onyx, is often the preferred embolic treatment for cerebral dural arteriovenous fistulas (DAVFs), there have only been a limited number of single-center studies to evaluate its performance.

Objective To carry out a multicenter study to determine the predictors of complications, obliteration, and functional outcomes associated with primary Onyx embolization of DAVFs.

Methods From the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database, we identified patients who were treated for DAVF with Onyx-only embolization as the primary treatment between 2000 and 2013. Obliteration rate after initial embolization was determined based on the final angiographic run. Factors predictive of complete obliteration, complications, and functional independence were evaluated with multivariate logistic regression models.

Results A total 146 patients with DAVFs were primarily embolized with Onyx. Mean follow-up was 29 months (range 0–129 months). Complete obliteration was achieved in 80 (55%) patients after initial embolization. Major cerebral complications occurred in six patients (4.1%). At last follow-up, 84% patients were functionally independent. Presence of flow symptoms, age over 65, presence of an occipital artery feeder, and preprocedural home anticoagulation use were predictive of non-obliteration. The transverse-sigmoid sinus junction location was associated with fewer complications, whereas the tentorial location was predictive of poor functional outcomes.

Conclusions In this multicenter study, we report satisfactory performance of Onyx as a primary DAVF embolic agent. The tentorium remains a more challenging location for DAVF embolization, whereas DAVFs located at the transverse-sigmoid sinus junction are associated with fewer complications.

http://dx.doi.org/10.1136/neurintsurg-2020-017109


 
 
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