Evaluating the Role of Onyx Embolization in the Management of Spinal Dural Arteriovenous Fistulas: A 20-Year Single-Center Experience

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10499784

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Evaluating the Role of Onyx Embolization in the Management of Spinal Dural Arteriovenous Fistulas: A 20-Year Single-Center Experience

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Evaluating the Role of Onyx Embolization in the Management of Spinal Dural Arteriovenous Fistulas: A 20-Year Single-Center Experience

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

World Neurosurgery

ISSN

1878-8750

e-ISSN

—

Svazek periodika

198

Číslo periodika v rámci svazku

JUNE 2025

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

6

Strana od-do

1-6

Kód UT WoS článku

001499463000002

EID výsledku v databázi Scopus

2-s2.0-105005186113