Comparison of transarterial n-BCA and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis

Abstract

Objective: Brain arteriovenous malformations (AVM) are commonly treated with endovascular embolization. Due to the rapid evolution of endovascular technology and lack of consistent practice guidelines regarding AVM embolization, further study of AVM embolization outcomes is warranted.Methods: We conducted a retrospective review of AVMs embolized at a single center from 2002-2019. Patient demographics, AVM characteristics, intention of embolization, and angiographic and clinical outcome after embolization were recorded. We compared the embolization results of those treated with n-butyl cyanoacrylate (n-BCA) and Onyx.Results: Over an 18-year period at our institution, 30 (33%) of 92 AVMs were treated with embolization. n-BCA was used in 12 cases and Onyx in 18 cases. Eighty-seven pedicles were embolized over 47 embolization sessions. Fifty percent of AVMs treated with n-BCA underwent more than one embolization session compared to 22% when Onyx was used. The median total percent volume reduction in the n-BCA AVMs was 52% compared to 51% in Onyx AVMs. There were 2 periprocedural complications in the n-BCA cohort and none in the Onyx cohort.Conclusions: In this small retrospective series, Onyx and n-BCA achieved similar occlusion results, although n-BCA required more sessions and pedicles embolized to do so.

Cervical extradural arteriovenous fistula with radiculopathy managed endovascularly

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A review of technological innovations leading to modern endovascular brain aneurysm treatment

“…Liquid embolization is most commonly utilized to treat arteriovenous malformations and fistulae, but has also been employed for intracranial aneurysms ( 69 ). Around the time of the first stand-alone coiling procedures, some clinicians began utilizing liquid embolization materials in tandem with other space-occupying embolic materials.…”

Comparison of transarterial n-BCA and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis

“…We read with great interest the recent article by Behzadi and colleagues entitled “Comparison of transarterial n-Butyl cyanoacrylate (n-BCA) and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis” [ 2 ]. We believe their principal finding of high safety when pursuing embolization using Onyx and n-BCA to be both encouraging and reflective of appropriate patient selection for standalone embolization treatment of brain arteriovenous malformations (AVMs).…”