Clinical Efficacy of Onyx Embolization in the Treatment of Distal Intracranial Microaneurysms

To investigate the feasibility of Onyx embolization in the treatment of intracranial distal microaneurysms.

Data of 14 patients (5 men and 9 women, aged 51 ± 9 years) who were diagnosed by Digital Subtraction Angiography (DSA) and underwent Onyx embolization were retrospectively analyzed. Anterior circulation was observed in 6 cases, posterior circulation in 8 cases, and rupture in 8 cases. All cases were evaluated by a multidisciplinary team (MDT), and Onyx embolization was performed after excluding the feasibility of conventional coil embolization and surgical clipping. Occlusion of the parent artery was performed in the posterior circulation, and the primary endpoint was the occlusion rate of the parent artery and the good rate at 6 months after surgery (mRS ≤2). Postoperative follow-up imaging.

The technical success rate was 100%, and the complication rate was 21% (3/14). The occlusion rate of the anterior circulation was 33%, and that of the posterior circulation was 100%. There was a significant difference in the occlusion rate of the parent artery in the anterior and posterior cerebral circulation (P = 0.0150) with good rates of 83% and 75%, respectively, and there was no statistical difference between the groups (P = 1.0000). No recurrence was observed in any of the 14 patients.

Onyx embolization may be an alternative treatment under certain circumstances. Onyx for the treatment of distal intracranial microaneurysms is effective and feasible, offering promising clinical outcomes. The long-term safety of personalized treatment strategies needs to be verified by large-sample studies.