Endovascular treatment of brain arteriovenous malformations using onyx: results of a prospective, multicenter study.
OBJECTIVE
To evaluate the safety and efficacy of onyx for embolization of brain arteriovenous malformations (BAVM).


METHODS
A prospective, multicenter study was conducted in France to evaluate embolization of BAVM with onyx. From May 2003 to March 2005, 50 patients (26 females, 24 males; mean age: 34.8 years, range: 16-64years) were included. Clinical presentation was haemorrhage in 22 patients (44.0%), seizures in 16 patients (32.0%), headaches in six patients (12.0%) and progressive neurological deficit in two cases (4.0%). Four patients were asymptomatic (8.0%).


RESULTS
One hundred and forty-ninesessions of embolization were performed: one to eight sessions/patient with a mean of 3.0sessions. One hundred and sixteen sessions (77.9%) were performed with onyx, 20 sessions (13.4%) with glue and 13 sessions (8.7%) with onyx and glue. Symptomatic acute postembolization haemorrhage (APEH) was observed in four cases (8.0% per patient). At 1 month, morbidity and mortality related to the treatment were of 8% and 2%, respectively. Complete BAVM occlusion was obtained in 8.3% of cases. In the remaining cases, occlusion rate was between 99 and 80% in 56.3% of patients, 79 and 60% in 16.7%, and less than 60 in 18.7%. In case of incomplete occlusion, complementary treatment was performed by radiosurgery.


CONCLUSIONS
Onyx is suitable for BAVM embolization with acceptable morbidity and mortality.
Pierot
L
L
Department of Radiology, hôpital Maison-Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France. lpierot@gmail.com
Januel
A-C
AC
Herbreteau
D
D
Barreau
X
X
Drouineau
J
J
Berge
J
J
Sourour
N
N
Cognard
C
C
D000293:Adolescent; D000328:Adult; D017130:Angioplasty; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide