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

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Cerebral dural arteriovenous fistulas (DAVFs) are complex vascular malformations.
• Onyx liquid embolic agent is a common treatment, but data is limited.
• Multicenter studies are needed to evaluate Onyx efficacy and safety.

Purpose of the Study:

• To assess predictors of complications, obliteration, and functional outcomes.
• To evaluate Onyx as a primary embolization agent for DAVFs.
• To analyze outcomes from a multicenter dataset.

Main Methods:

• Retrospective analysis of 146 patients from the CONDOR database (2000-2013).
• Primary treatment with Onyx-only embolization for DAVFs.
• Multivariate logistic regression to identify predictive factors for outcomes.

Main Results:

• 55% of patients achieved complete obliteration after initial Onyx embolization.
• Major cerebral complications occurred in 4.1% of patients.
• 84% of patients were functionally independent at follow-up; predictors for non-obliteration and outcomes were identified based on location and patient factors.

Conclusions:

• Onyx demonstrates satisfactory performance as a primary embolic agent for DAVFs.
• Transverse-sigmoid sinus junction DAVFs have fewer complications.
• Tentorial DAVFs present a greater challenge for successful embolization and functional outcomes.