title: The utility of onyx for preoperative embolization of cranial and spinal tumors.
abstract: OBJECTIVE
  To assess the utility, technical factors, and complications associated with the use of Onyx (Micro Therapeutics, Inc., Irvine, CA) for preoperative embolization of cranial and spinal tumors.
  
  
  METHODS
  We reviewed a prospectively accumulated database for patients in whom Onyx was used for preoperative embolization of cranial and spinal tumors over a 19-month period. The patients' demographic characteristics, tumor type and location, embolic agents used, arteries catheterized, and associated complications were assessed. Specific attention was focused on technical factors associated with the use of Onyx that differed from the use of other commonly used embolic materials.
  
  
  RESULTS
  Ten patients (four female and six male; age range, 11-60 yr) underwent preoperative embolization with Onyx before cranial or spinal tumor resection. Tumors included three juvenile nasal angiofibromas, two meningiomas, two hemangioblastomas, two metastases (renal cell and thyroid), and one giant cell tumor. Onyx embolization was performed in 43 vessels over 11 treatment sessions. There were no complications related to the embolization procedures. Deep penetration of the embolic agent into the tumor was documented through preoperative imaging or surgical pathological specimens.
  
  
  CONCLUSIONS
  Preoperative embolization of cranial and spinal tumors can be performed safely. Specific technical advantages of Onyx included deep penetration of lesions producing extensive tumor infarction, the ability to embolize extensive portions of the tumors through fewer arterial catheterizations, and the safety of catheter withdrawal despite often substantial reflux along the embolic catheter.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gore
authors.forename: Nicholas
authors.initials: N
authors.lastname: Theodore
authors.forename: Leonardo
authors.initials: L
authors.lastname: Brasiliense
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Kim
authors.forename: Mark
authors.initials: M
authors.lastname: Garrett
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: Cameron G
authors.initials: CG
authors.lastname: McDougall
authors.forename: Felipe C
authors.initials: FC
authors.lastname: Albuquerque
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011145:Polyvinyls / Q000627:therapeutic use*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide