The efficacy and limitations of transarterial acrylic glue embolization for the 
treatment of intracranial dural arteriovenous fistulas (DAVFs) were 
investigated. Thirty-four DAVFs treated by transarterial embolization using 
n-butyl cyanoacrylate were retrospectively reviewed. The locations of DAVFs were 
the transverse-sigmoid sinus in 11, tentorium in 10, cranial vault in 9, and 
superior sagittal sinus, jugular bulb, foramen magnum, and middle cranial fossa 
in 1 each. Borden classification was type I in 7, type II in 3, and type III in 
24. Eight patients had undergone prior transvenous coil embolization. Complete 
obliteration rate was 56% immediately after embolization, 71% at follow-up 
angiography, and 85% after additional treatments (1 transvenous embolization and 
4 direct surgery). Complications occurred in three patients, consisting of 
asymptomatic vessel perforations during cannulation in two patients and leakage 
of contrast medium resulting in medullary infarction in one patient. 
Transarterial glue embolization is highly effective for Borden type III DAVF 
with direct cortical venous drainage, but has limitations for Borden type I and 
II DAVFs in which the affected sinus is part of the normal venous circulation. 
Onyx is a new liquid embolic material and is becoming the treatment of choice 
for DAVF. The benefits of glue embolization compared to Onyx embolization are 
high thrombogenicity, and relatively low risks of cranial nerve palsies and of 
excessive migration into the draining veins of high flow fistula. Transarterial 
glue embolization continues to be useful for selected patients, and complete 
cure can be expected in most patients with fewer complications if combined with 
transvenous embolization or direct surgery.