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Research ArticleINTERVENTIONAL

Embolization of Intracranial Arteriovenous Malformations with Ethylene-Vinyl Alcohol Copolymer (Onyx)

V. Panagiotopoulos, E. Gizewski, S. Asgari, J. Regel, M. Forsting and I. Wanke
American Journal of Neuroradiology January 2009, 30 (1) 99-106; DOI: https://doi.org/10.3174/ajnr.A1314
V. Panagiotopoulos
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E. Gizewski
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S. Asgari
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J. Regel
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M. Forsting
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I. Wanke
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    Fig 1.

    A 48-year-old male patient with an SM grade II AVM in the left cerebellar lobe. A and B, Vertebral angiogram (lateral view, arterial and late venous phase) shows arterial supply to the AVM from feeders of the left posterior inferior cerebellar artery with superficial venous drainage. C, Unobstructed image illustrates a solid Onyx cast after the embolization. D, Left vertebral angiogram (lateral view, venous phase) illustrates complete AVM occlusion after embolization through a single pedicle.

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    Fig 2.

    A 29-year-old female patient with an SM grade IV AVM in the right occipital lobe. A, Vertebral angiogram (lateral view) shows arterial supply from multiple feeders arising mainly from the right posterior artery with superficial venous drainage. B, Right internal carotid artery angiogram (lateral view) shows additional arterial supply to the AVM from feeders of the middle cerebral artery. C, Unobstructed image illustrates a solid Onyx cast after the embolization. D and E, Control right vertebral and carotid artery angiograms (lateral view) at 6 months after embolization illustrate persistence of complete occlusion with no evidence of recanalization. F, MR image (time-of-flight, axial) at 6 months after embolization reveals complete occlusion of the AVM without evidence of reperfusion.

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    Fig 3.

    A 53-year-old male patient with an SM grade I AVM in the right frontal lobe. A, Right internal carotid angiogram (lateral view) shows arterial supply to the AVM from feeders of the right pericallosal artery with superficial venous drainage. B, Right internal carotid angiogram (lateral view, early venous phase) illustrates complete AVM occlusion after embolization. C, Postembolization cerebral CT scan (axial) illustrates the Onyx cast with subtotal penetration inside the AVM nidus. D, Control right carotid artery angiogram (lateral view) at 4 months after embolization demonstrates partial recanalization of the AVM nidus with reconstitution of early venous drainage.

Tables

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    Table 1:

    Patients’ characteristics at admission

    CharacteristicsNo.
    Demographics
        Male41
        Female41
        Age (yr) (mean)44.2 (15–85)
    Presenting symptoms
        Intracerebral hemorrhage37
        Seizure18
        Neurologic deficit8
        Headache9
        Incidental10
    SM scale
        I–II59
        III16
        IV–V7
    • Note:—SM indicates Spetzler-Martin.

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    Table 2:

    Location of brain AVMs

    LocationNo.
    Frontal10
    Temporal19
    Parietal7
    Occipital13
    Frontotemporal2
    Frontoparietal5
    Temporo-occipital2
    Temporoparietal2
    Parieto-occipital5
    Intraventricular2
    Temporochoroidal1
    Basal ganglia1
    Cerebellar13
    • Note:—AVMs indicates arteriovenous malformations.

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American Journal of Neuroradiology: 30 (1)
American Journal of Neuroradiology
Vol. 30, Issue 1
January 2009
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Embolization of Intracranial Arteriovenous Malformations with Ethylene-Vinyl Alcohol Copolymer (Onyx)
V. Panagiotopoulos, E. Gizewski, S. Asgari, J. Regel, M. Forsting, I. Wanke
American Journal of Neuroradiology Jan 2009, 30 (1) 99-106; DOI: 10.3174/ajnr.A1314

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Embolization of Intracranial Arteriovenous Malformations with Ethylene-Vinyl Alcohol Copolymer (Onyx)
V. Panagiotopoulos, E. Gizewski, S. Asgari, J. Regel, M. Forsting, I. Wanke
American Journal of Neuroradiology Jan 2009, 30 (1) 99-106; DOI: 10.3174/ajnr.A1314
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  • Hemorrhagic Complications after Endovascular Treatment of Cerebral Arteriovenous Malformations
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  • Curative Embolization of Brain Arteriovenous Malformations with Onyx: Patient Selection, Embolization Technique, and Results
  • Microsurgical retrieval of an endovascular microcatheter trapped during Onyx embolization of a cerebral arteriovenous malformation
  • Treatment of Brain Arteriovenous Malformations by Double Arterial Catheterization with Simultaneous Injection of Onyx: Retrospective Series of 17 Patients
  • Cerebral haemorrhage from a remote varix in the venous outflow of an arteriovenous malformation treated successfully by embolisation
  • Brain Arteriovenous Malformation Treatment Using a Combination of Onyx and a New Detachable Tip Microcatheter, SONIC: Short-Term Results
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