Abstract | BACKGROUND AND PURPOSE: The purpose of this study was to demonstrate endovascular treatment of wide-necked aneurysms of the internal carotid artery with the liquid embolic agent Onyx HD 500. METHODS: Twenty-two wide-necked, large or giant aneurysms of the internal carotid artery (ICA) were treated in 22 patients with Onyx HD 500 (15 ophthalmic, 1 clinoid, and 6 cavernous aneurysms). Sixteen patients were asymptomatic, and mass effect of the aneuryms caused cranial nerve palsy in 6. Seven aneurysms showed regrowth after prior endovascular coiling. RESULTS: Postinterventional angiography demonstrated total occlusion in 18 aneurysms, and a small remnant was left in 4. Clinical and angiographic follow-up data are available in 19 patients (average follow-up, 13 months; range, 5-36 months). Total occlusion was demonstrated in 17 aneurysms (91%), and a partial recanalization was seen in 2. There were 2 ICA occlusions and 1 ICA stenosis. Clinical follow-up demonstrated a transient ischemic attack in 1 patient; 2 with cranial nerve palsy were unchanged, and 2 showed improved symptoms compared with the findings before treatment. The remaining 14 patients were clinically asymptomatic. There was no permanent severe morbidity and no mortality at follow-up. CONCLUSION: The endovascular treatment of wide-necked, large or giant ICA aneurysms with Onyx HD 500 is a treatment option in these selected cases. The benefit is a primary high and stable occlusion rate and good clinical outcome. ICA occlusion caused by Onyx migration in the parent artery is a typical problem, with a benign clinical course in this series.
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Authors | Werner Weber, Ralf Siekmann, Bernhard Kis, Dietmar Kuehne |
Journal | AJNR. American journal of neuroradiology
(AJNR Am J Neuroradiol)
Vol. 26
Issue 8
Pg. 1909-15
(Sep 2005)
ISSN: 0195-6108 [Print] United States |
PMID | 16155133
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Onyx HD 500
- Polyvinyls
- Dimethyl Sulfoxide
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Topics |
- Adult
- Carotid Artery, Internal
- Cerebral Angiography
- Dimethyl Sulfoxide
(therapeutic use)
- Embolization, Therapeutic
(adverse effects, methods)
- Female
- Follow-Up Studies
- Foreign-Body Migration
(etiology)
- Humans
- Intracranial Aneurysm
(diagnostic imaging, therapy)
- Male
- Middle Aged
- Polyvinyls
(therapeutic use)
- Treatment Outcome
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