The Utility of Onyx for Preoperative Embolization of Cranial and Spinal Tumors

Abstract

Preoperative embolization of cranial and spinal tumors can be performed safely. Specific technical advantages of Onyx included deep penetration of lesions producing extensive tumor infarction, the ability to embolize extensive portions of the tumors through fewer arterial catheterizations, and the safety of catheter withdrawal despite often substantial reflux along the embolic catheter.

Preoperative Onyx Embolization of Glomus Jugulare Tumor Complicated by Surgical Displacement of Embolic Material: Case Report

“…A new substance introduced in the past several years which is gaining more widespread use is Onyx Liquid Embolic System (LES), an ethylene vinyl copolymer in suspension with tantalum powder in dimethyl-sulfoxide (DMSO), which is delivered by microcatheter. Onyx LES has gained popularity because of its reported advantages in achieving more extensive tumor devascularization, using fewer arterial catheterizations, and doing so with a greater safety profile during catheter withdrawal [4].…”

“…It has been used more recently as adjuvant therapy prior to definitive surgical resection in the embolization of paragangliomas [1], meningiomas [2], vertebral hemangiomas [3], juvenile nasal angiofibromas [4], among other tumors. Onyx LES is becoming more frequently used because it has been reported to offer particular advantages including more extensive tumor devascularization, the use of fewer arterial catheterizations, and greater safety during catheter withdrawal [4]. In this paper, we describe a rare complication of surgical displacement of Onyx LES embolic material from a preoperatively embolized glomus jugulare tumor.…”

The Treatment Outcome of Transarterial Embolization for Isolated Sinus Type Dural Arteriovenous Fistula between NBCA and Onyx

“…The frequency of the occurrence of gluing of a microcatheter has been reported to be 2.5%-3.2%. 14,16) If it happens in cerebral arteriovenous malformation, there is a risk of brain parenchymal hemorrhage, 17) but this risk is low in dural arteriovenous fistula (DAVF), which is usually approached via the arteries from external carotid artery or dural artery. 9) However, the risk of ischemic complications increases if of using Onyx for the treatment of DAVF 9,10) with more favorable complete occlusion rates of 70%-95%.…”

Imaging diagnosis and the role of endovascular embolization treatment for vascular intraspinal tumors

“…2,69 Many investigators have reported that preoperative endovascular embolization of vascular intraspinal tumors primarily facilitates resection and secondarily reduces the mortality and morbidity associated with resection, improving the clinical outcome. 9,12,32,38,48,52,77 The presence of a radiculomedullary artery in close proximity to or from the same pedicle as the tumor-feeding arteries is considered a contraindication to embolization, as an inadvertent occlusion of spinal arteries may occur. 9,71,90 In addition, arteriovenous shunting within the tumor, visualization of a radiculomedullary artery via intersegmental anastomoses, uncorrectable coagulopathy, and renal failure represent relative contraindications to intraspinal tumor embolization.…”