scholarly journals Onyx injection by direct puncture for presurgical embolization of a C2 hypervascular metastasis from a thyroid cancer

2021 ◽  
pp. neurintsurg-2020-017180
Author(s):  
Frédéric Clarençon ◽  
Pierre-Emmanuel Moreau ◽  
Jonathan Cortese ◽  
Gauthier Eloy ◽  
Frédéric Deschamps ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Neurological Complications ◽  
Embolic Agent ◽  
Direct Puncture ◽  
Content Type ◽  
Massive Blood Loss ◽  
Spinal Lesion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Video Player

Surgery for spinal hypervascular lesions, such as hemangioma or metastases from thyroid or renal cancer, may be challenging because of the risk of massive blood loss.1 To overcome this limitation, presurgical embolization has gained acceptance to reduce this risk.2 However, some configurations, such as the origin of a radiculomedullary artery close to the vessels feeding the lesion or when the lesion is supplied by vessels feeding an eloquent territory, may limit the possibility of presurgical embolization, especially with microparticles.3 Direct percutaneous puncture of the spinal lesion and subsequent embolization with liquid embolic agent may be a valuable option in such challenging cases.4We present a case of presurgical embolization of a C2 metastasis from a thyroid cancer using Onyx-18 injected by direct puncture (video 1). In this technical video, we stress the technical aspects of the direct puncture technique and the safety rules to avoid neurological complications.Video 1

Embolization of spinal cord arteriovenous malformations with an ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide (Onyx liquid embolic system)

2000 ◽  
Vol 93 (2) ◽  
pp. 304-308 ◽  
Author(s):  
Andrew J. Molyneux ◽  
Stuart C. Coley
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations ◽  
Embolic Agent ◽  
Endovascular Management ◽  
Content Type ◽  
Ethylene Vinyl Alcohol ◽  
Promising Agent ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Brain Avms

✓ In this paper the authors describe the first use of a new liquid embolic agent (Onyx) to treat spinal cord arteriovenous malformations (AVMs). Because its properties make it more predictable to use than currently available liquid agents, the authors believe that this material has great potential in the endovascular management of both spinal cord and brain AVMs. This very promising agent merits further clinical study.

A mixture of ethylene vinyl alcohol copolymer and ethanol yielding a nonadhesive liquid embolic agent to treat cerebral arteriovenous malformations: initial clinical experience

2002 ◽  
Vol 97 (4) ◽  
pp. 881-888 ◽  
Author(s):  
Jun-Ichiro Hamada ◽  
Yutaka Kai ◽  
Motohiro Morioka ◽  
Kiyoshi Kazekawa ◽  
Yasuji Ishimaru ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Vinyl Alcohol ◽  
Arteriovenous Malformations ◽  
Embolic Agent ◽  
Ethanol Mixture ◽  
Content Type ◽  
Ethylene Vinyl Alcohol ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Fine Print

Object. The authors report their clinical experience with their new nonadhesive liquid embolic agent, an ethylene vinyl alcohol copolymer (EVAL)/ethanol mixture, to treat arteriovenous malformations (AVMs). Methods. Between June 1995 and April 2001, 57 patients with confirmed AVMs underwent embolization of their lesions with the EVAL/ethanol mixture. In 87 procedures consisting of one to three stages, the authors embolized 185 feeding arteries to occlude as much of the AVM as possible. Repeated injections under fluoroscopic control could be performed smoothly without encountering cementing of the catheter to the vessel wall. Among the 87 embolizations undertaken in 57 patients, seven procedures (8%) in six patients produced new postembolization symptoms. Resolution of these symptoms occurred within hours or days after four of the seven procedures; permanent neurological deficits remained after the other three procedures (3.4%). Of the 57 patients, three underwent postembolization radiosurgery, and 54 underwent radical treatment with microsurgical extirpation. Histopathological examination of the 54 specimens disclosed mild inflammation within the embolized lumen without inflammatory reactions in the media or adventitia. Follow-up angiograms obtained 3 years after radiosurgery was administered showed that in all three patients treated in this fashion the nidus had completely disappeared. Conclusions. The EVAL/ethanol mixture is handled easily and appears to be an effective and safe agent for preoperative embolization of AVMs.

scholarly journals Giant Hepatic Artery Aneurysm Associated with Immunoglobulin G4-Related Disease Successfully Treated Using a Liquid Embolic Agent

2015 ◽  
Vol 16 (4) ◽  
pp. 953 ◽  
Author(s):  
Michele Rossi ◽  
Edoardo Virgilio ◽  
Florindo Laurino ◽  
Gianluigi Orgera ◽  
Paolo Menè ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Artery Aneurysm ◽  
Embolic Agent ◽  
Hepatic Artery Aneurysm ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

scholarly journals Investigation of a New Version of the Liquid Embolic Agent PHIL with Extra-Low-Viscosity in an Endovascular Embolization Model

2018 ◽  
Vol 39 (9) ◽  
pp. 1696-1702 ◽  
Author(s):  
D.F. Vollherbst ◽  
R. Otto ◽  
M. Hantz ◽  
C. Ulfert ◽  
H.U. Kauczor ◽  
...  
Keyword(s):  
Endovascular Embolization ◽  
Embolic Agent ◽  
Low Viscosity ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

scholarly journals Re-treatment of residual aneurysms after flow diversion: An experimental study

2018 ◽  
Vol 31 (3) ◽  
pp. 270-279 ◽  
Author(s):  
Robert Fahed ◽  
Tim E Darsaut ◽  
Marc Kotowski ◽  
Igor Salazkin ◽  
Jean Raymond
Keyword(s):  
Flow Diverter ◽  
Artery Occlusion ◽  
Flow Diversion ◽  
Embolic Agent ◽  
Parent Artery ◽  
Arterial Lumen ◽  
Parent Artery Occlusion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Flow Diverters

Aim Flow diverters are increasingly used to treat aneurysms, but treatment is not always effective. The management of aneurysms that fail to occlude following flow diversion is problematic. We aimed to reproduce failures in an animal model and study re-treatment with additional flow diverters alone or with flow diverters and liquid embolic agent. Material and methods Twenty wide-necked aneurysms were created at the carotid-lingual bifurcation in 10 dogs, and were treated with flow diverters 4–6 weeks later. Follow-up angiography was performed at three months. Suitable residual aneurysms were randomly allocated: re-treatment with flow diverters alone ( n = 6), or with the injection of liquid embolic between two layers of flow diverters ( n = 4) or no re-treatment ( n = 2). Angiography was repeated three months later, followed by euthanasia, photography and pathology. Results Patent wide-necked aneurysms were produced in 17/20 attempts (85%); three months after flow diversion there were 15/17 (88%) residual aneurysms. In three cases, re-treatment was not possible because the flow diverter had prolapsed into the aneurysm, leaving 12 aneurysms to study. Re-treated aneurysms showed improved angiographic results at six months (median score of 2; P = 0.03), but residual aneurysms were present in all cases. Parent artery occlusion occurred in two aneurysms treated with flow diverter plus liquid embolic. At pathology, aneurysms were only partially filled with thrombus; leaks through the flow diverters were found in the neointima connecting the arterial lumen to residual aneurysms. Conclusion Re-treatment of residual flow-diverted experimental aneurysms with additional flow diverters did not lead to aneurysm occlusion.

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