Document Detail

Treatment of brain arteriovenous malformations by double arterial catheterization with simultaneous injection of Onyx: retrospective series of 17 patients.
MedLine Citation:
PMID:  20966066     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: The use of Onyx in the treatment of intracranial AVMs has increased the cure rate of endovascular embolization compared with the use of liquid adhesive agents. Inadvertent occlusion of the draining veins before the complete exclusion of the nidus constitutes a major risk of bleeding. We report a case series using the technique of double simultaneous arterial catheterization as an approach to achieve the complete exclusion of the nidus before reaching the venous drainage, through a more controlled hemodynamic filling.
MATERIALS AND METHODS: Between April 2008 and November 2009, 17 patients with brain AVMs were treated by the DACT. The mean age of the patients was 32.7 years (range, 6-54 years), with 9 females and 8 males. The clinical onset was characterized by intracranial hemorrhage in 8 patients and by seizures in 7. The size of the AVMs ranged from 13 to 54 mm (average, 26.2 mm). The DACT was always used with the objective of curing the AVM.
RESULTS: All 17 patients completed the EVT. The average number of sessions conducted was 1.4 (range, 1-3 sessions), with the average injection amount of 6.9 mL of Onyx (range, 2-25.2 mL). Sixteen AVMs (94.1%) were angiographically cured by embolization. Clinical complications occurred in 2 patients (11.7%); 1 of these was permanent (5.9%). No deaths were registered.
CONCLUSIONS: This preliminary series shows that the DACT presents satisfactory results when used with curative intent.
D G Abud; R Riva; G S Nakiri; F Padovani; M Khawaldeh; C Mounayer
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-10-21
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  32     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-14     Completed Date:  2011-05-10     Revised Date:  2011-09-12    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-8     Citation Subset:  IM    
Division of Interventional Neuroradiology, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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MeSH Terms
Balloon Occlusion / methods*
Cerebral Arteries / drug effects
Combined Modality Therapy
Dimethyl Sulfoxide / administration & dosage*
Hemostatics / administration & dosage
Injections, Intra-Arterial
Intracranial Arteriovenous Malformations / therapy*
Middle Aged
Polyvinyls / administration & dosage*
Young Adult
Reg. No./Substance:
0/Hemostatics; 0/Onyx copolymer; 0/Polyvinyls; 67-68-5/Dimethyl Sulfoxide
Comment In:
Clin Neuroradiol. 2011 Jun;21(2):107-9   [PMID:  21656259 ]

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