Ендоваскулярна нейрорентгенохірургія (Mar 2017)
Our experience of composition at onyx embolization of arteriovenous malformations
Abstract
Objective – to assess the safety and efficacy of Onyx embolization in the treatment of intracranial arteriovenous malformations (AVM). Materials and methods. Patients with cerebral arterio-venous malformations were included into the study. The Spetzler-Martin grade distribution was as follows: III – 6 (33 %), IV – 9 (50 %), V – 3 (17 %). They were treated by embolization for brain AVM by using Onyx-18 and a microcatheter with detachable tip. Treatment of cerebral AVM requires the use of most modern achievements in neurosurgery. This applies advanced diagnostic and therapeutic techniques. Our research is devoted to the initial experience of Onyx and microcatheter with the tip, which is separated. Onyx main advantage compared to other means emboline is its ability to provide a slow and controlled delivery over an extended time interval. This provides better penetration into the cell and a higher degree of penetration of AVM. Microcatheter with the tip that separates specifically designed to fully exploit the benefits of Onyx. In our view the application Onyx radical obliteration is not dependent on the number afferents of AVM and the location of the tip microcatheter as intranidal. Our results showed that the treatment of AVM strategy using Onyx leads to a high degree of occlusion with minor complications, most of which are transient. Results. The main advantage of Onyx compositions over other embolic agents is the ability to provide a slow and controlled delivery over an extended time. This contributes to a better penetration into the hearth and a higher degree of penetration AVM. When using Onyx radicalism obliteration does not depend on the number of AVM afferents, but depend on the intranidal location of the tip of the microcatheter. The use of the microcatheter with detachable tip adds several advantages, higher volumes of Onyx can be safely injected. Conclusions. The use of a composition Onyx possible and safe enough for embolization of cerebral arteriovenous malformations. The total off AVM can be achieved in a small package malformations. Large AVM can be reduced in size before surgery or radiosurgery. If using the composition Onyx embolization AVM process is more manageable. It shows the ability to control the spread em- boline means the body malformations, preventing its penetration in intact arteries and draining veins, which in turn reduces the risk of ischemic and bleeding complications.
