Using Onyx in endovascular embolization of internal carotid artery large or giant aneurysms

Eur J Radiol. 2012 Aug;81(8):1858-62. doi: 10.1016/j.ejrad.2011.04.008. Epub 2011 May 6.


Background and purpose: 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.

Conclusion: Endovascular embolization with Onyx is a useful treatment for ICA large or giant aneurysms, which is unsuitable for coiling or surgical treatment.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / diagnostic imaging*
  • Aneurysm / therapy*
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / therapy*
  • Carotid Artery, Internal / diagnostic imaging*
  • Dimethyl Sulfoxide / therapeutic use*
  • Embolization, Therapeutic / methods*
  • Endovascular Procedures / methods
  • Female
  • Hemostatics / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Polyvinyls / therapeutic use*
  • Radiography
  • Treatment Outcome


  • Hemostatics
  • Onyx copolymer
  • Polyvinyls
  • Dimethyl Sulfoxide