Angiographic exclusion of intracranial arteriovenous malformations using onyx®

Historically, endovascular treatment for cerebral arteriovenous malformations (AVMs) has been reserved as an adjunct to other modalities, namely radiosurgery and microsurgery, as the cure rate for cerebral AVMs treated solely with endovascular technique and older embolic agents is low. We report a series of five consecutive patients treated successfully with Onyx®, the newest available embolic agent, with resultant angiographic cure. Five patients aged three, nine, 33, 49, and 63 years were treated endovascularly for cerebral AVMs with a total of 19 embolizations with Onyx(®). All procedures were performed under general anesthesia with biplanar fluoroscopy. Complete angiographic obliteration of the AVM nidus was obtained in all cases with no residual filling. No immediate hemorrhagic or thromboembolic complications were observed. This early experience suggests that Onyx® has excellent embolization potential, and endovascular cure of AVMs may now be achieved with single modality therapy. Long terms data needs to be collected to further validate this observation.