Onyx Embolization of Sporadic Angiomyolipoma

Abstract

Percutaneous embolization is the currently preferred treatment of symptomatic or ruptured renal angiomyolipomas (AMLs). Alcohol, microparticles, and coils are usually used. We present what is to our knowledge the first case of successful embolization of a solitary sporadic AML with the use of a new nonadhesive liquid embolic agent (ethylene vinyl alcohol copolymer; Onyx). Onyx injection was slow and controllable and achieved complete tumor devascularization, producing a characteristic appearance like a vascular cast. Short-term follow-up magnetic resonance imaging showed complete tumor necrosis without any recurrent pathologic vessels. The specific features, potential advantages in AML treatment, and technical limitations of this new liquid embolic agent are discussed.

Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study

“…In accordance with the literature, this series confirms that Onyx ® is both effective and safe in treating peripheral lesions, which strengthens the possibility to use it in different anatomical sites. As already highlighted by various authors, Onyx ® can be used for the embolization of all peripheral hemorrhages (3,16), aneurysms, type II endoleaks (17), hemoptysis (18), cutaneous AVMs (6), angiomyolipoma (19). Besides, in our study, 6 patients (12%) underwent preoperative portal embolization using Onyx ® without any complication, a fact that has yet never been described in the literature.…”

Early side effects after embolization of a carotid body tumor using Onyx

“…In general, patients must be informed of two of its characteristics before Onyx embolization: it produces a garlic-like taste and breath odor during the first postembolization day, and emission of sparks may occur when Onyxembolized tissue is surgically resected with monopolar electrocautery devices because of the tantalum powder content. 19 To prevent the risk of migration of Onyx into the internal carotid artery, a balloon was placed into the internal carotid artery during embolization. However, enoral paraesthesia, Horner syndrome, and deficits of the hypoglossal and glossopharyngeal nerves appeared with a delay of between 3 and 10 hours after Onyx embolization, which we believe was not due to direct toxicity of DMSO but to mechanical compression caused by swelling of the paraganglioma after embolization or inflammation after Onyx embolization.…”

Tratamento endovascular de angiomiolipoma renal por embolização arterial seletiva

“…Angiomyolipomas (AML) are rare benign tumors that account for 2% to 3% of all renal tumors [1][2][3][4][5][6][7] . They are twice more frequent among women 1,5,6,8 .…”

“…They are twice more frequent among women 1,5,6,8 . Most are sporadic, but 10% are associated with tuberous sclerosis complex (TSC) [1][2][3][4][5][6][7][9][10][11] .…”

“…AML are hamartomas that contain fat, blood vessels and muscle fibers [1][2][3][4][5][6][7][8][9][10][11][12][13] .…”