Preoperative Embolization of Cerebral Arteriovenous Malformations with Onyx

Article Figures & Data

Table 1:

Demographics and arteriovenous malformation specifics in 36 patients who underwent preoperative embolization with Onyx

Characteristics	Before Embolization	After Embolization	P value
Age (y); median (range)	41 (12–62)
Sex, no. pts (%)
Male	15 (37)
Female	26 (63)
Presentation, no. pts (%)
Hemorrhage	19 (46)
Other (seizure/headache)	22 (54)
AVM specifics
Side, no. pts (%)
Left	19 (46)
Right	20 (49)
Midline	2 (5)
Location, no. pts (%)
Supratentorial	36 (88)
Infratentorial	5 (12)
Eloquence^*, no. pts (%)	31 (77)	18 (50)	1.00
Size^† (cm), mean ± SD	3.70 ± 1.55	3.06 ± 1.89	< .05
Deep venous drainage, no. pts (%)	20 (54)	18 (50)	.16
No. (%) pts with reduced SMG		10 (24)	< .05

Note:—AVM indicates arteriovenous malformation; no. pts, number of patients; SMG, Spetzler-Martin grade.
* Eloquent regions included deep structures such as the hypothalamus, thalamus, brainstem, and cerebellar peduncles as well as cortical regions such as the sensorimotor, language, and primary visual areas.
† Maximal diameter of the perfused nidus.

Table 2:

Complications of preoperative embolization of cerebral arteriovenous malformations with Onyx

Complication	No. of Procedures (%)	No. of Patients (%)
Death	0 (0)	0 (0)
Permanent neurological deficit (> 6 mo)	5 (6.1)	5 (12.2)
Transient neurological deficit (< 48 h)	2 (2.4)	2 (4.8)
Technical complication without deficit	16 (19.5)	15 (36.6)
Asymptomatic small infarction	3 (3.7)	3 (7.3)
Perforation	9 (11.0)	9 (22.0)
Catheter entrapment	4 (4.9)	4 (9.8)
No complication	59 (72.0)	19 (46.3)
Total	82 (100)	41 (100)

Table 3:

Literature reporting on preoperative embolization of cerebral arteriovenous malformations with Onyx

1^st Author	Year	N^†	Surgery	Radiosurgery	“Cured”^*	Mean	Per Procedure		Per Patient
1^st Author	Year	N^†	No. Pts (%)	No. Pts (%)	No. Pts (%)	Size (cm)	Morb. (%)	Mort. (%)	Morb. (%)	Mort. (%)
Jahan	2001	23	12 (52)	11 (48)	0 (0)	3.6	3.0	0	4	0
Hamada	2002	57	54 (95)	3 (5)	0 (0)	–	3.4	0	5.3	0
van Rooij	2007	44	10 (23)	20 (45)	7 (16)	3.9	3.8	1.9	4.6	2.3
Weber	2007	47	47 (100)	0 (0)	0 (0)	3.4	12	0	28	0
Weber	2007	93	56 (60)	13 (14)	17 (18)	–	5	0	12	0
Mounayer	2007	94	7 (7)	20 (21)	26 (28)	–	3.8	1.4	8.5	3.2
Hauck	Current	41	29 (71)	6 (15)	2 (5)	3.7	6.1	0	12	0

Note:—N indicates total number of patients; Morb., morbidity; Mort., mortality.
* Complete occlusion without recurrence.
† Only patients treated with Onyx are included.