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  • Title: Endovascular treatment of brain arteriovenous malformations using onyx: results of a prospective, multicenter study.
    Author: Pierot L, Januel AC, Herbreteau D, Barreau X, Drouineau J, Berge J, Sourour N, Cognard C.
    Journal: J Neuroradiol; 2009 Jun; 36(3):147-52. PubMed ID: 19223075.
    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.
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