title: Using Onyx in endovascular embolization of internal carotid artery large or giant aneurysms.
abstract: OBJECTIVE
  Internal carotid artery (ICA) large or giant saccular aneurysms is challenging for endovascular coil embolization and surgical clipping with a high recanalization and rebleeding rate. We report our results using Onyx in the endovascular treatment of ICA large or giant saccular aneurysms.
  
  
  METHODS
  During 2008-2010, 5 patients with 5 large or giant saccular aneurysms in ICA were treated with a liquid embolic agent (Onyx; Micro Therapeutics, Irvine, CA). One aneurysm was small (<10mm), 2 were large (≥10mm, <25mm) and 2 were giant saccular aneurysms (≥25mm). Of 3 female and 2 male patients, 3 were incidental and 2 had bleeding. Selective embolization was performed with Onyx alone or a combination with coils. Clinical and anatomic outcomes were assessed with the Modified Glasgow Outcome Scale and follow-up angiography was performed at 4-21 months (mean 12.2 months).
  
  
  RESULTS
  Complete aneurysm occlusion was obtained in all of the aneurysms on immediate control angiogram. There was not any procedure-related complication. No recanalization was observed at the follow- up periods. There were 2 ICA occlusions in giant ICA aneurysms. The 5 patients were all clinically asymptomatic at follow-up.
  
  
  CONCLUSIONS
  Endovascular embolization with Onyx is a useful treatment for ICA large or giant aneurysms, which is unsuitable for coiling or surgical treatment.
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Region, Shenyang, Liaoning, PR China. liangguobiao6708@163.com
authors.forename: Guobiao
authors.initials: G
authors.lastname: Liang
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Li
authors.forename: Xu
authors.initials: X
authors.lastname: Gao
authors.forename: Haifeng
authors.initials: H
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Lin
authors.forename: Shize
authors.initials: S
authors.lastname: Feng
authors.forename: Xuedong
authors.initials: X
authors.lastname: Wei
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide