title: Ethylene vinyl alcohol copolymer (onyx) embolization for acute hemorrhage: a systematic review of peripheral applications.
abstract: OBJECTIVE
  To evaluate the endovascular use of ethylene vinyl alcohol (EVOH) copolymer (Onyx; ev3 Endovascular, Inc, Plymouth, Minnesota) for the treatment of acute peripheral nonneurologic hemorrhage.
  
  
  METHODS
  MEDLINE and PubMed databases were searched for articles published in English from 1946 to August 2014 describing patients treated for hemorrhage with EVOH copolymer outside of its usual neurovascular applications. Additional cases were collected from the bibliographies of relevant articles. Full-text articles were obtained. Demographic data, clinical presentation, underlying etiology, culprit vessel, endovascular treatment, outcomes, and follow-up times were obtained.
  
  
  RESULTS
  The literature search yielded 19 relevant articles. Cases of 131 patients (87 men, 44 women; mean age, 61 y ± 19.2) describing the treatment of 151 lesions were reviewed. The most common categories of arterial lesions were gastrointestinal (n = 53) and bronchial (n = 40) in origin. In 14 cases, EVOH copolymer was employed after failure or rebleeding following the use of a different embolic agent. Average follow-up time was 12.0 months. EVOH copolymer was the sole embolic agent used in 105 patients. Rebleeding after treatment with EVOH copolymer occurred in 10 patients. There were 2 technical failures. One patient died of multiorgan failure in the setting of persistent hemoptysis. Complications included 2 nerve injuries and 2 minor strokes.
  
  
  CONCLUSIONS
  Embolization of acute hemorrhage in the peripheral vasculature was safe and effective with EVOH copolymer.
authors: Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003.
authors: Marcin K
authors: MK
authors: Kolber
authors: Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003.
authors: Pratik A
authors: PA
authors: Shukla
authors: Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003.
authors: Abhishek
authors: A
authors: Kumar
authors: Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003. Electronic address: jsilberzweig@chpnet.org.
authors: James E
authors: JE
authors: Silberzweig
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage* / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide