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Related Experiment Video

Updated: Mar 14, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Onyx in Brain Arteriovenous Malformation Embolisation.

Hilwati Hashim1, A Sobri Muda2, Aida Abdul Aziz3

  • 1Imaging Unit, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.

The Malaysian Journal of Medical Sciences : MJMS
|September 24, 2016
PubMed
Summary

This study evaluated ethylene vinyl alcohol copolymer (Onyx) for brain arteriovenous malformation (bAVM) embolisation. While Onyx offers better control, the study reported higher morbidity and mortality rates in a small patient cohort.

Keywords:
Onyx copolymerangiographyarteriovenous malformationsbutylcyanoacrylatetherapeutic embolisation

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Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Vascular Neurology

Background:

  • Embolisation is a key treatment for brain arteriovenous malformations (bAVMs).
  • Traditional n-butylcyanoacrylate glue has rapid polymerization, posing handling challenges.
  • Ethylene vinyl alcohol copolymer (Onyx) offers slower polymerization and improved control for embolisation procedures.

Purpose of the Study:

  • To assess the use of Onyx, alone or with histoacryl, for bAVM embolisation.
  • To report on the experience within a tertiary referral center.

Main Methods:

  • Retrospective review of bAVM patients treated with Onyx.
  • Analysis of anatomical details, procedural conditions, complications, and clinical outcomes.
  • Inclusion of patients treated between 2010 and 2013.

Main Results:

  • 13 patients underwent 31 embolisation procedures for bAVMs.
  • Hemorrhage was the most common presentation (69.2%).
  • Complete occlusion was achieved in 15.4% of patients; 84.6% had partial occlusion.
  • Morbidity was 23.1% and mortality was 7.7% in this cohort.

Conclusions:

  • Nidal occlusion rates are comparable to existing literature.
  • Higher morbidity and mortality may be linked to the small sample size.
  • Further data collection is ongoing to better evaluate the center's experience with Onyx embolisation.