Surgical Resection Following Onyx Embolization for Brain Arteriovenous Malformations

DOI 17 References
  • TOKUNAGA Koji
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • SUGIU Kenji
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • HISHIKAWA Tomohito
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • KUROZUMI Kazuhiko
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • OKUMA Yu
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • ITAMI Hisakazu
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • ONO Shigeki
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • DATE Isao
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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  • Onyxによる術前塞栓術を併用した脳動静脈奇形の外科的摘出術

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A new embolic material for brain arteriovenous malformations (AVMs)—Onyx liquid embolic system—has become available in Japan. We report our initial experience with surgical resection of AVMs after Onyx embolization and the pathological findings of the resected specimens.<br> AVMs of three patients were embolized with Onyx followed by surgical resection. A high rate of Onyx penetration into the nidus was obtained when the plug of Onyx was formed around the tip of the microcatheter navigated as closely to the nidus as possible. Otherwise, Onyx injection resulted in partial occlusion of the nidus or proximal occlusion of the feeders. Total resection of the nidus was safely achieved in every case. The plane of dissection between the brain and the embolized nidus that demonstrated a firm consistency was easily identified. Uncontrollable bleeding from the perinidal capillary network was rarely encountered. Pathological examination did not show angionecrosis in the walls of the embolized vessels. Infiltration of macrophages was observed in the embolized vessels in the specimens resected more than five days after embolization.<br> Onyx embolization followed by surgical resection is a safe and effective treatment for AVMs.<br>

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