title: Predictive Factors for Response of Intracranial Dural Arteriovenous Fistulas to Transarterial Onyx Embolization: Angiographic Subgroup Analysis of Treatment Outcomes.
abstract: OBJECTIVE
  Endovascular treatment using Onyx has been increasingly used to treat intracranial dural arteriovenous fistulas (DAVFs). This study evaluated predictive factors for favorable treatment outcome in patients with intracranial noncavernous DAVFs treated by transarterial Onyx embolization.
  
  
  METHODS
  Between August 2008 and August 2014, 55 patients who underwent transarterial Onyx embolization for noncavernous DAVFs were retrospectively reviewed. Patients' demographic, clinical, and procedural data were analyzed to find statistically significant predictive factors for favorable treatment outcomes after Onyx embolization. Fistulas were classified angiographically according to the relationship between fistulas and dural venous sinuses and the presence of leptomeningeal venous reflux.
  
  
  RESULTS
  Sixty-eight Onyx embolizations were performed in 55 patients. Immediate angiographic cure was achieved in 28 patients, and 14 of 27 patients with residual shunts showed progressive occlusion at follow-up imaging studies. Therefore, the overall favorable treatment outcome was 76.4% (42/55). The remaining 13 patients (23.6%) showed persistent residual shunts, and 3 (5.5%) of them showed aggravation of residual lesion on follow-up studies. Of 25 patients with non-sinus fistulas, 23 patients (92%) showed favorable treatment outcomes, and 19 of 30 patients (63.3%) with sinus fistulas showed favorable outcomes. Among the evaluated variables, non-sinus DAVFs was a statistically significant predictive factor for favorable response to transarterial Onyx embolization (P < 0.05).
  
  
  CONCLUSIONS
  Transarterial Onyx embolization is a highly effective treatment method for non-sinus DAVFs. Careful consideration of angiographic features and multimodal embolization strategies are required for treatment of sinus DAVFs.
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Byungjun
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. Electronic address: drpjeon@gmail.com.
authors.forename: Pyoung
authors.initials: P
authors.lastname: Jeon
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Keonha
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sungtae
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyungjin
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Byun
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Il
authors.initials: KI
authors.lastname: Jo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Central nervous system; Dimethyl sulfoxide; Embolization; Radiography; Therapeutic methods; Therapeutic use; Therapy; Treatment outcomes; Vascular malformations