Mounayer C, Hammami N, Piotin M, Spelle L, Benndorf G, Kessler I, Moret J
Department of Interventional Neuroradiology, Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
AJNR Am J Neuroradiol. 2007 Mar;28(3):518-23.
To report our experience in the treatment of brain arteriovenous malformations (BAVMs) using Onyx (ev3, Irvine, Calif).
From January 1999 to October 2004, 94 patients with BAVMs were treated endovascularly in our department. They were 51 (54%) men and 43 (46%) women with a mean age of 32 years. A total of 210 endovascular procedures were performed with Onyx as the sole embolic agent in 88 procedures; Onyx and n-butyl cyanoacrylate (n-BCA) were used in combination in 50 procedures, and n-BCA alone was used in 72 procedures.
The course of endovascular treatment was completed in 53 patients. In 26 patients (49%, 26/53) an angiographic cure was achieved using embolization as the sole therapeutic technique. Seven (13%, 7/53) patients underwent a surgical resection of the residual BAVM nidus, 20 (38%, 20/53) patients underwent radiosurgical treatment after nidal size reduction <2 cm was accomplished by endovascular treatment. Further endovascular treatment was planned in 33 patients, whereas in 5 patients, the continuation of embolization was aborted due to difficult nidus catheterization. Procedure-related permanent neurologic deficits were observed in 8 (8.5%, 8/94) patients. There were 3 procedure-related deaths.
Onyx is suitable for brain BAVM embolizations and allows obtaining higher rates of anatomic cures compared with those obtained previously with other embolic agents.
报告我们使用Onyx（ev3公司，加利福尼亚州欧文市）治疗脑动静脉畸形（BAVMs）的经验。
1999年1月至2004年10月，我们科室对94例BAVM患者进行了血管内治疗。其中男性51例（54%），女性43例（46%），平均年龄32岁。共进行了210次血管内操作，88次操作仅使用Onyx作为栓塞剂；50次操作联合使用Onyx和正丁基氰基丙烯酸酯（n-BCA），72次操作仅使用n-BCA。
53例患者完成了血管内治疗过程。26例患者（49%，26/53）通过栓塞作为唯一治疗技术实现了血管造影治愈。7例（13%，7/53）患者对残留的BAVM病灶进行了手术切除，20例（38%，20/53）患者在通过血管内治疗使病灶大小缩小至<2 cm后接受了放射外科治疗。计划对33例患者进一步进行血管内治疗，而5例患者因病灶插管困难而中止了栓塞治疗。8例（8.5%，8/94）患者出现了与操作相关的永久性神经功能缺损。有3例与操作相关的死亡病例。
Onyx适用于脑BAVM栓塞，与之前使用其他栓塞剂相比，能获得更高的解剖学治愈率。
