Advertisement

Aneurysm Treatment with Liquid Embolics

  • Andrew J. Ringer
  • Ralph Rahme
Chapter

Abstract

During the past decade, Onyx® HD-500 (Medtronic Neurovascular, USA), a high-viscosity liquid embolic agent, has been used extensively to treat intracranial aneurysms. Preliminary experience using this relatively novel agent was rewarding in terms of high-occlusion rates and low-recanalization rates of large and wide-necked aneurysms [1, 2]. Use of Onyx HD-500 has since decreased dramatically with the increasing popularity of flow diverters as first-line treatment for complex intracranial aneurysms. Nevertheless, it remains a useful endovascular tool for select patients who are not good candidates for flow diversion because of recurrent stent-embolized aneurysms or nickel allergy.

References

  1. 1.
    Mawad ME, Cekirge S, Ciceri E, Saatci I. Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection. J Neurosurg. 2002;96:474–82.CrossRefPubMedGoogle Scholar
  2. 2.
    Tevah J, Senf R, Cruz J, Fava M. Endovascular treatment of complex cerebral aneurysms with Onyx HD-500(®) in 38 patients. J Neuroradiol. 2011;38:283–90.CrossRefPubMedGoogle Scholar
  3. 3.
    Molyneux AJ, Cekirge S, Saatci I, Gál G. Cerebral Aneurysm Multicenter European Onyx (CAMEO) trial: results of a prospective observational study in 20 European centers. AJNR Am J Neuroradiol. 2004;25:39–51.PubMedGoogle Scholar
  4. 4.
    Simon SD, Eskioglu E, Reig A, Mericle RA. Endovascular treatment of side wall aneurysms using a liquid embolic agent: a US single-center prospective trial. Neurosurgery. 2010;67:855–60.CrossRefPubMedGoogle Scholar
  5. 5.
    Cekirge HS, Saatci I, Ozturk MH, Cil B, Arat A, Mawad M, et al. Late angiographic and clinical follow-up results of 100 consecutive aneurysms treated with Onyx reconstruction: largest single-center experience. Neuroradiology. 2006;48:113–26.CrossRefPubMedGoogle Scholar
  6. 6.
    ev3 Inc. Onyx® HD-500. http://www.ev3.net/neuro/us/liquid-embolics/onyx-hd500-liquid-embolic-system.htm. Accessed 31 Oct 2011.Google Scholar
  7. 7.
    Weber W, Siekmann R, Kis B, Kuehne D. Treatment and follow-up of 22 unruptured wide-necked intracranial aneurysms of the internal carotid artery with Onyx HD 500. AJNR Am J Neuroradiol. 2005;26:1909–15.PubMedGoogle Scholar
  8. 8.
    Piske RL, Kanashiro LH, Paschoal E, Agner C, Lima SS, Aguiar PH. Evaluation of Onyx HD-500 embolic system in the treatment of 84 wide-neck intracranial aneurysms. Neurosurgery. 2009;64:E865–75.CrossRefPubMedGoogle Scholar
  9. 9.
    Rahme R, Ringer AJ, Abruzzo TA, Grande AW, Jimenez L. Predicting parent vessel patency and treatment durability: a proposed grading scheme for the immediate angiographic results following Onyx HD-500 embolization of intracranial aneurysms. J Neurointerv Surg. 2014;6(10):754–60.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Director of NeurosurgeryGood Samaritan HospitalCincinnatiUSA
  2. 2.Chief of Neurosciences, TriHealth SystemCincinnatiUSA
  3. 3.Mayfield Brain and SpineCincinnatiUSA
  4. 4.Division of NeurosurgeryLenox Hill Hospital, Northwell HealthNew YorkUSA

Personalised recommendations