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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Endovascular and surgical treatment of intracranial arteriovenous malformations with OnyxTM: Results after intervention, surgery and follow-up

Endovaskuläre und operative Behandlung von intrakraniellen arteriovenösen Malformationen mit OnyxTM: Postinterventionelle und postoperative Ergebnisse und Verlaufsuntersuchungen

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  • corresponding author Bernhard Kis - Department of Neurology, Alfried Krupp Hospital, Essen
  • W. Weber - Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen
  • S. Nickel - Department of Neurosurgery, Alfried Krupp Hospital, Essen
  • J. Wirtz - Department of Neurosurgery, Alfried Krupp Hospital, Essen
  • P. Jans - Department of Neurosurgery, Alfried Krupp Hospital, Essen
  • R. Laumer - Department of Neurosurgery, Alfried Krupp Hospital, Essen
  • D. Kühne - Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.03.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0038.shtml

Published: April 23, 2004

© 2004 Kis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To demonstrate the combined endovascular and surgical treatment of intracranial arteriovenous malformations (AVM) with the novel liquid embolic agent OnyxTM.

Methods

Between 10/2001 and 10/2003, 65 patients (pt.) with 66 AVM were treated. 53 AVM were designated to be treated by a combination of endovascular and surgical therapy, 10 by embolisation and radiation and 3 by palliative embolisation alone. We present the results of 49 AVM which were treated by embolisation and surgery.

Results

A mean of 2.6 endovascular steps were performed per pt. and 3.1 feeders were embolised. 21 AVM were located in eloquent brain areas. The mean volume of AVM was 7.5ml and that of injected OnyxTM was 3.6ml per AVM. 14 AVM were eliminated by embolisation alone and 33 by combined therapy. In 2 pt. the treatment is not finished yet. The mean occlusion rate was 89±14%. A severe deficit (mod. Rankin Scale>2) appeared in 2 pt. after embolisation, in 5 after surgery. The follow-up data after a minimum of 6 months were currently collected.

Conclusions

The use of OnyxTM allows a curative embolisation in 22% and a high nidal occlusion. Multiple penetrations of OnyxTM into the nidus from the same catheter position reduces the number of feeders to be treated before surgery and allows precise and gentle resection. The angiographic and clinical results confirm this method as a safe treatment option of intracranial AVM.