Abstract
Onyx is a new liquid embolic system (Micro Therapeutics, Inc., Irvine, CA) consisting of ethylene-vinyl alcohol copolymer (EVOH), formed of 48 mol/L ethylene and 52 mol/L vinyl alcohol, dissolved in dimethyl-sulfoxide (DMSO) and mixed with micronized tantalum powder (35% weight per volume) for radiopaque visualization. In its low density form it is predominantly used worldwide in the treatment of cerebral 1-6 or spinal7,8 arteriovenous malformations (AVMs), other more rare indications are hypervascularized tumors9, peripheral AVMs or arteriovenous fistulas (AVFs)10, and there is also an extensive use in experimental work 11-12. Onyx LD means low density of EVOH in the range of 6 to 8 % (Onyx 18 to 34) compared to high density Onyx 500+ (containing 20 % of EVOH) used for aneurysm occlusions. The basics of Onyx LD liquid system and the main principles of its application in endovascular AVM therapy are described and discussed in this chapter.
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