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

• Published in: Journal of neuroradiology Vol. 36; no. 3; pp. 147 - 152
• Main Authors: Pierot, L, Januel, A.-C, Herbreteau, D, Barreau, X, Drouineau, J, Berge, J, Sourour, N, Cognard, C
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.06.2009
• Subjects: Adolescent; Adult; Angioplasty; Brain arteriovenous malformations; Dimethyl Sulfoxide - therapeutic use; Embolization; Embolization, Therapeutic; Endovascular treatment; Female; Follow-Up Studies; Humans; Intracranial Arteriovenous Malformations - therapy; Male; Middle Aged; Onyx; Polyvinyls - therapeutic use; Prospective Studies; Radiology; Treatment Outcome; Young Adult; Embolization; Brain arteriovenous malformations; Onyx; Endovascular treatment
• ISSN: 0150-9861
• DOI: 10.1016/j.neurad.2008.11.005

Summary 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: 16–64 years) 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-nine sessions of embolization were performed: one to eight sessions/patient with a mean of 3.0 sessions. 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.