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Updated: Jun 20, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Revascularization of Onyx induced intra-operative occlusion of vertebro-basilar artery using the Merci device
Shon G Michael1, Amar S Swarnkar, Julius Gene S Latorre
1Department of Neurology, 7135 University Hospital, Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
Introduction:
Endovascular embolization is an important modality in the treatment of cerebral arteriovenous malformations (AVMs). Onyx is an ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide that is approved for use as an embolic agent for brain AVMs.
Case Report:
We describe a case of revascularization of an occluded vertebro-basilar artery during embolization of an AVM with Onyx, by using the Merci device.
Conclusion:
Reflux embolization of patent vessels is a rare complication of using Onyx to treat AVMs. It can be successfully managed by retrieving the Onyx substance using mechanical retrieval devices like the Merci device.
