title: Transarterial Onyx embolization of intracranial dural arteriovenous fistulas: a single center experience.
abstract: BACKGROUND
  Transarterial embolization of intracranial dural arteriovenous fistulas (DAVFs) is usually associated with inadequate embolization. The purpose of this study was to report our experience of transarterial Onyx embolization of intracranial DAVFs with an emphasis on treatment outcome with this new embolic agent in different types of DAVFs.
  
  
  METHODS
  In the past 3 years, a total of 14 intracranial DAVFs have been treated by transarterial Onyx embolization. Among these, there were nine males and five females, aged from 30 years to 82 years (mean = 62 years). We retrospectively analyzed the injection volume and time of Onyx embolization as well as outcomes in different types of DAVFs.
  
  
  RESULTS
  The locations of the DAVFs were sigmoid sinus (n = 6), tentorium (n = 3), sinus confluence (n = 2), transverse-sigmoid sinus (n = 1), sigmoid sinus-jugular bulb (n = 1) and the superior petrous sinus (n = 1). The mean volume and time of Onyx injection were 3.4 mL and 28 minutes, respectively (Cognard type I: 4.9 mL, 40 minutes; type II: 4.5 mL, 34 minutes; type III: 2.2 mL, 21 minutes; type IV: 2 mL, 22 minutes). Total fistula occlusion was achieved in six out of seven patients of type III and type IV DAVFs, and in four out of seven patients of type I and type II DAVFs. Nine patients had total resolution of their symptoms, whereas partial regression occurred in five patients. No significant periprocedural complication was found. Mean clinical follow-up period was 16 months.
  
  
  CONCLUSIONS
  Transarterial Onyx embolization of intracranial DAVFs is safe and effective. This technique is particularly useful in type III and type IV DAVFs with a high cure rate, and lower volume of Onyx as well as a short injection time.
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Radiology, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: cbluo@vghtpe.gov.tw.
authors.forename: Chao-Bao
authors.initials: CB
authors.lastname: Luo
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Feng-Chi
authors.initials: FC
authors.lastname: Chang
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Michael
authors.initials: M
authors.lastname: Mu-Huo Teng
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Chung-Jung
authors.initials: CJ
authors.lastname: Lin
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Hsiu-Mei
authors.initials: HM
authors.lastname: Wu
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Wan-Yuo
authors.initials: WY
authors.lastname: Guo
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D003287:Contrast Media / Q000627:therapeutic use*; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D012189:Retrospective Studies; D013635:Tantalum / Q000627:therapeutic use*
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; C558446:Onyx 18; D011145:Polyvinyls; D013635:Tantalum
keywords: Onyx; dural arteriovenous fistula; endovascular embolization