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Onyx embolization for the treatment of brain arteriovenous malformations.
MedLine Citation:
PMID:  21046174     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Onyx has emerged in recent years for the endovascular treatment of brain arteriovenous malformations (AVMs). However, the role of Onyx embolization is still under discussion. We report our initial experiences in the treatment of brain AVMs with Onyx embolization.
METHODS: Between January 2004 and December 2007, 86 patients with brain AVMs were embolized with Onyx. Clinical presentation included intracerebral hemorrhage in 32 patients, seizures in 25 patients, headaches in 20 patients, neurologic deficits in 3 patients, and in 6 patients the AVM was an incidental finding. According to the Spetzler-Martin scale, three AVMs were grade I, 13 were grade II, 45 were grade III, 19 were grade IV, and 6 were grade V. Seventy-four AVMs were located in eloquent regions.
RESULTS: Initial complete obliteration after final embolization was achieved in 16 patients (18.6%), with an average of 80.5% (range, 30-100%) volume reduction. Partial embolization was followed by surgery in 18 patients, whereas 17 AVMs were cured. In 48 patients treated by embolization and radiosurgery, four patients were lost to follow-up. Three-year follow-up angiography was performed on 30 patients and showed complete obliteration after radiosurgery in 23 patients. The remaining 14 patients are awaiting 3-year postradiosurgery results. Embolization-related permanent morbidity was 3.5%, whereas mortality was 1.2%.
CONCLUSIONS: Although Onyx allows moderate obliteration rates, combined management, such as adjunctive embolization with microsurgery or radiosurgery, may be effective for selected large AVMs.
Feng Xu; Wei Ni; Yujun Liao; Yuxiang Gu; Bin Xu; Bing Leng; Donglei Song
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Publication Detail:
Type:  Journal Article     Date:  2010-10-28
Journal Detail:
Title:  Acta neurochirurgica     Volume:  153     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  869-78     Citation Subset:  IM    
Department of Neurosurgery, Huashan Hospital, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
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