Outcomes of Onyx embolisation as primary treatment for intracranial dural arteriovenous fistulas over the past two decades

作者：Xin Su, Zihao Song, Yiguang Chen, Hongqi Zhang, Peng Zhang, Yongjie Ma · 发表于：Stroke and Vascular Neurology · 年份：2025 · DOI：10.1136/svn-2025-004611 · 被引用次数：1 · 研究领域：Vascular Malformations Diagnosis and Treatment、Cerebral Venous Sinus Thrombosis、Neurosurgical Procedures and Complications

BACKGROUND: Most current studies on Onyx are limited by small sample sizes and often involve its use in combination with other embolic materials, with few investigations specifically evaluating Onyx as a sole embolic agent. METHODS: Using the Dural Arteriovenous Fistula Research and Management in China (DREAM-INI) database, we identified patients who underwent primary treatment for dural arteriovenous fistula (DAVF) with Onyx-only embolisation. Data collected included patient demographics, comorbidities, clinical manifestations, DAVF location, arterial supply, Borden and Cognard classifications, endovascular modalities, angiographic results, complications, and both clinical and angiographic follow-up. Multivariate logistic regression analyses were conducted to identify predictors of immediate complete obliteration, complications and poor clinical outcomes. RESULTS: A total of 471 patients with DAVFs underwent primary embolisation using Onyx. The median duration of clinical follow-up was 35.0 months (IQR 10.0-75.3), while the median angiographic follow-up was 24.0 months (IQR 8.0-63.0). Immediate complete obliteration was achieved in 417 patients (88.5%). Procedure-related complications occurred in 31 cases (6.6%). At the final follow-up, 90.6% of patients demonstrated good clinical outcomes. Borden type III DAVFs were positively associated with immediate complete obliteration, whereas the presence of occipital and pial artery feeders was negatively associated. Tentorial locat...