Abstract:

BACKGROUND: As for the endovascular embolization treatment of cerebral arteriovenous malformations, the embolic materials play a greatly decisive role on the therapeutic effect. Onyx is a new liquid embolic agent developed in recent years, with non-stick tube, dispersion uniformity and good controllability.
OBJECTIVE: To summarize the embolization techniques and clinical efficacy of cerebral arteriovenous malformation by using a new liquid embolic agent (Onyx).
METHODS: Thirty-one patients with cerebral arteriovenous malformation were treated with Onyx, 6F sheath inserted into femoral artery using Seldinger technique followed by 6F guiding catheter introduced into the internal carotid artery or vertebral artery, Marathon micro-catheter could be navigated into the nidus of arteriovenous malformation, then the Onyx was injected slowly into the cerebral arteriovenous malformation with “inject-back flow-stop-reinject” technique.
RESULTS AND CONCLUSION: 40%-60% embolizations were achieved in 8 cases, 60%-90% in 7 cases, more than 90% (complete embolization) in 16 cases. Among 15 cases of incomplete embolization, 4 underwent surgical removal including 3 cases with good outcome and 1 case of hemiplegia with muscular strength of degree Ⅳ; 6 cases were treated by γ-knife after embolization, 2 cases of them showed complete occlusion after radiosurgery. Onyx has unique and distinctive superiority in treating cerebral arteriovenous malformations. However, the embolization techniques should be well trained to get good results and avoid complications.