Brain AVM embolization with Onyx and post-embolic management

Abstract

Objective To report our experience in the treatment of brain arteriovenous malformations (BAVMs)with Onyx and discuss the post-embolic management. Methods 21 BAVMs patients confirmed by angiography Were embolized with Onyx and dealed with subsequent treatment(follow-up,stereotactic radiosurgery or microsurgery)according to the embolization results.Results Eight cases (38%)were completely obliterated after embolization while one case suffered a small subarachnoid hemorrhage.Four cases(19%)were subtotally embolized while one patient suffered severe cerebral edema after embolization and further intracranial infection after decompressive craniectomy who was lost for follow-up,2 patients had additional radiosurgery and 1 patient had follow-up.Nine patients(43%)were partially embolized,5 patients had additional surgery,2 patients had additional radiosurgery and 2 patients had follow-up(1 patient had intraventricular hemorrhage 3 months after embolization).Conclusions onyx is suitable in the embolization of BAVMs for its diffuse and controllable properties.Additional radiosurgery or follow-up is suggested after subtotal embolization and additional surgery should be firstly considered after partially embolization. Key words: Onyx; Brain arteriovenous malformations; Embolization