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[Liquid embolic agents--Onyx as problem solver]
W A Wohlgemuth1, W Uller, R Müller-Wille
1Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 1, Regensburg, Germany. walter.wohlgemuth@ukr.de
Clinical/Methodical Issue:
Liquid embolic agents are used for permanent occlusion of capillaries but optimal administration properties are lacking.
Standard Radiological Methods:
The lack of visualization by fluoroscopy and the risk of serious complications are disadvantages of conventional embolic agents, such as ethanol and Histoacryl.
Methodical Innovations:
Onyx is a liquid embolic agent consisting of ethylene vinyl alcohol copolymer dissolved in various concentrations of dimethyl sulfoxide (DMSO) and suspended micronized tantalum powder to provide contrast for fluoroscopy.
Performance:
The physicochemical characteristics of Onyx allow controlled application, forming a defined cast and permanent occlusion. Disadvantages are the high costs. Furthermore, the solvent DMSO requires special catheter material and causes pain during Onyx application.
Achievements:
Onyx has been primarily used for interventional neuroradiological treatment but peripheral applications are becoming increasingly more common.
Practical Recommendations:
Currently, Onyx is mainly used for embolotherapy of endoleaks after endovascular aortic aneurysm repair, for treatment of acute arterial bleeding and for treatment of arteriovenous malformations.
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