Preoperative Embolization of Extra-axial Hypervascular Tumors with Onyx.
OBJECTIVE
Preoperative endovascular embolization of intracranial tumors is performed to mitigate anticipated intraoperative blood loss. Although the usage of a wide array of embolic agents, particularly polyvinyl alcohol (PVA), has been described for a variety of tumors, literature detailing the efficacy, safety and complication rates for the usage of Onyx is relatively sparse.


METHODS
We reviewed our single institutional experience with pre-surgical Onyx embolization of extra-axial tumors to evaluate its efficacy and safety and highlight nuances of individualized cases.


RESULTS
Five patients underwent pre-surgical Onyx embolization of large or giant extra-axial tumors within 24 hours of surgical resection. Four patients harbored falcine or convexity meningiomas (grade I in 2 patients, grade II in 1 patient and grade III in one patient), and one patient had a grade II hemangiopericytoma. Embolization proceeded uneventfully in all cases and there were no complications.


CONCLUSIONS
This series augments the expanding literature confirming the safety and efficacy of Onyx in the preoperative embolization of extra-axial tumors, underscoring its advantage of being able to attain extensive devascularization via only one supplying pedicle.
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Matthew R
MR
Fusco
Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Mohamed M
MM
Salem
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
Bradley A
0000-0003-2599-5182
BA
Gross
Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Arra S
AS
Reddy
Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Christopher S
CS
Ogilvy
Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Ekkehard M
EM
Kasper
Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Ajith J
AJ
Thomas
Embolization; Endovascular; Meningioma; Onyx; Tumor