Background and purpose
To evaluate the safety and efficacy of onyx for embolization of brain arteriovenous malformations (BAVM).
A prospective, multicenter study was conducted in France to evaluate embolization of BAVM with onyx. From May2003 to March2005, 50patients (26females, 24males; mean age: 34.8years, range: 16–64years) were included. Clinical presentation was haemorrhage in 22patients (44.0%), seizures in 16patients (32.0%), headaches in six patients (12.0%) and progressive neurological deficit in two cases (4.0%). Four patients were asymptomatic (8.0%).
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, 20sessions (13.4%) with glue and 13sessions (8.7%) with onyx and glue. Symptomatic acute postembolization haemorrhage (APEH) was observed in four cases (8.0% per patient). At 1month, 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.
Onyx is suitable for BAVM embolization with acceptable morbidity and mortality.Le texte complet de cet article est disponible en PDF.
Keywords : Brain arteriovenous malformations, Embolization, Endovascular treatment, Onyx