Onyx embolization for the endovascular treatment of infectious and traumatic aneurysms involving the cranial and cerebral vasculature

J Neurointerv Surg. 2013 Nov;5(6):562-5. doi: 10.1136/neurintsurg-2012-010460. Epub 2012 Nov 6.

Abstract

Background: Onyx is a liquid non-adhesive viscous embolic agent ideal for slow targeted injections which is currently approved for the treatment of intracranial aneurysms and arteriovenous malformations.

Methods: We performed a single-center retrospective analysis of consecutive patients who underwent off-label use of Onyx as the single embolic agent for the treatment of traumatic or infectious pseudoaneurysms involving the cerebral or cranial vasculature.

Results: A total of nine pseudoaneurysms treated by Onyx embolization were identified. Six of the pseudoaneurysms were post-surgical, one of the pseudoaneurysms was traumatic and two were infectious in nature. The mean pseudoaneurysm size was 5.9 mm (range 2-10 mm). Onyx-34 was used in all cases. Following treatment there was complete exclusion of all pseudoaneurysms including their inflow and outflow zones.

Conclusions: Our experience demonstrates the efficacy and applicability of the use of Onyx in the treatment of complex traumatic and mycotic pseudoaneurysms involving the cerebral and cranial vascular tree.

Keywords: Aneurysm; Hemorrhage; Infection; Liquid Embolic Material; Technique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aneurysm, False / complications
  • Aneurysm, Infected / therapy*
  • Anterior Cerebral Artery / pathology
  • Brain Injuries / complications*
  • Brain Neoplasms / complications
  • Brain Neoplasms / surgery
  • Carcinoma, Squamous Cell / complications
  • Central Nervous System Fungal Infections / pathology
  • Central Nervous System Fungal Infections / therapy
  • Cerebral Angiography
  • Cerebrovascular Circulation / physiology
  • Combined Modality Therapy
  • Dimethyl Sulfoxide*
  • Embolization, Therapeutic / methods*
  • Endocarditis, Subacute Bacterial / complications
  • Endovascular Procedures / methods*
  • Female
  • Glioblastoma / complications
  • Glioblastoma / surgery
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / etiology
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Middle Cerebral Artery / pathology
  • Polyvinyls*
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Streptococcal Infections / complications
  • Treatment Outcome
  • Young Adult

Substances

  • Onyx copolymer
  • Polyvinyls
  • Dimethyl Sulfoxide