Evaluating the Role of Onyx Embolization in the Management of Spinal Dural Arteriovenous Fistulas: A 20-Year Single-Center Experience
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F25%3A00001519" target="_blank" >RIV/61383082:_____/25:00001519 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/25:10499784
Result on the web
<a href="https://pubmed.ncbi.nlm.nih.gov/40294791/" target="_blank" >https://pubmed.ncbi.nlm.nih.gov/40294791/</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.wneu.2025.124016" target="_blank" >10.1016/j.wneu.2025.124016</a>
Alternative languages
Result language
angličtina
Original language name
Evaluating the Role of Onyx Embolization in the Management of Spinal Dural Arteriovenous Fistulas: A 20-Year Single-Center Experience
Original language description
Background: Open surgery is widely regarded as the standard treatment for spinal dural arteriovenous fistulas (SDAVFs). However, endovascular treatment (EVT) with liquid embolic agents has emerged as an alternative. While N-butyl cyanoacrylate is often preferred for its superior penetration into draining vein, this study aims to assess the effectiveness of an embolization-first strategy using Onyx, drawing on 20 years of clinical experience. Methods: A retrospective analysis included 50 patients treated between 2004 and 2024. Only patients undergoing EVT as the first-line therapy for SDAVF were included. Results: Overall, EVT achieved complete occlusion in 38 (76%) cases, with an additional 6 (12%) requiring adjuvant surgery resulting in definitive cure. In the remaining 6 (12%) patients, embolization of the feeding artery and fistula nidus led to permanent clinical improvement (n = 4, 66%) or stability (n = 2, 33%), supported by indirect fistula signs regression on follow-up magnetic resonance imaging. Onyx was solely used in 84% of EVTs, achieving a complete occlusion rate of 83%. Clinical improvement or stabilization was observed in 46 (92%) patients, with no recurrences in successfully treated patients. There was no EVT-related complication. Follow-up magnetic resonance imagings showed regression of perimedullary varices and regression or stability of myelopathy in all cases (n = 50, 100%). Conclusions: The embolization-first strategy, with adjuvant surgery when necessary, can achieve outcomes nearing those of purely surgical approaches. Based on our long-term experience, EVT with Onyx can result in complete and permanent cure of SDAVF in more than 80% of cases.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30103 - Neurosciences (including psychophysiology)
Result continuities
Project
—
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
World Neurosurgery
ISSN
1878-8750
e-ISSN
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Volume of the periodical
198
Issue of the periodical within the volume
JUNE 2025
Country of publishing house
US - UNITED STATES
Number of pages
6
Pages from-to
1-6
UT code for WoS article
001499463000002
EID of the result in the Scopus database
2-s2.0-105005186113