title: Transarterial coil-augmented Onyx embolization for brain arteriovenous malformation. Technique and experience in 22 consecutive patients.
abstract: Onyx has been widely adopted for the treatment of arteriovenous malformations (AVMs). However, its control demands operators accumulate a considerable learning curve. We describe our initial experience using a novel injection method for the embolization of AVMs. We retrospectively reviewed the data of all 22 patients with brain AVMs (12 men, 10 women; age range, 12-68 years; mean age, 43.2 years) treated by the transarterial coil-augmented Onyx injection technique. The size of the AVMs ranged from 25 mm to 70 mm (average 35.6 mm). The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated. In every case, endovascular treatment (EVT) was completed. A total of 31 sessions were performed, with a mean injection volume of 6.1 mL (range, 1.5-16.0 mL). An average of 96.7% (range 85%-100%) estimated size reduction was achieved, and 18 AVMs could be completely excluded by EVT alone. The results remained stable on follow-up angiograms. A procedural complication occurred in one patient, with permanent mild neurologic deficit. Our preliminary series demonstrated that the coil-augmented Onyx injection technique is a valuable adjunct achieving excellent nidal penetration and improving the safety of the procedure.
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China - liangguobiao6708@163.com.
authors.forename: Xu
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Guobiao
authors.initials: G
authors.lastname: Liang
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Chunyong
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Cao
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Command; Shenyang, China.
authors.forename: Jingyuan
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D002536:Cerebral Arteries / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006490:Hemostatics; C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Onyx; arteriovenous malformation; coil; embolization; endovascular treatment