Endovascular treatment of brain arteriovenous malformations using onyx: results of a prospective, multicenter study

J Neuroradiol. 2009 Jun;36(3):147-52. doi: 10.1016/j.neurad.2008.11.005. Epub 2009 Feb 14.

Abstract

Background and purpose: 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.

Conclusion: Onyx is suitable for BAVM embolization with acceptable morbidity and mortality.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Angioplasty*
  • Dimethyl Sulfoxide / therapeutic use*
  • Embolization, Therapeutic*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Arteriovenous Malformations / therapy*
  • Male
  • Middle Aged
  • Polyvinyls / therapeutic use*
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Onyx copolymer
  • Polyvinyls
  • Dimethyl Sulfoxide