Endovascular treatment of side wall aneurysms using a liquid embolic agent

A US single-center prospective trial

Scott Simon, Eric Eskioglu, Adam Reig, Robert A. Mericle

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: Onyx HD-500 is a liquid embolic agent consisting of ethylene vinyl alcohol copolymer dissolved in dimethylsulfoxide and mixed with tantalum. This viscous embolic agent was designed to treat intracranial side wall aneurysms, but there have been no prospective published series from the United States. From this early experience, we developed several protocol revisions, technical details, and clinical pearls that have not been published for liquid embolic embolization of aneurysms. Clinical presentation: We present our single-center prospective series of patients treated with Onyx HD-500 from a multicenter, randomized, controlled trial. Thirteen patients received Onyx HD-500, and their ages ranged from 43 to 81 years. Twelve patients had aneurysms on the internal carotid artery, and 1 patient had an aneurysm the vertebral artery. Every patient had an immediate postangiographic result with 90% or more occlusion by an independent core laboratory assessment. In 1 patient, the Onyx HD-500 injection was aborted, and the aneurysm was embolized with coils. Eleven of 13 patients (85%) underwent 6-month follow-up angiography that demonstrated persistent durable occlusion with no recanalization. There was 1 complication (8%) and no deaths. Conclusion: This is the only prospective series of intracranial aneurysms treated with Onyx HD-500 in the United States. This is also the first publication that describes detailed procedure techniques, recommended protocol revisions, lessons learned from early complications, clinical pearls, and advantages and disadvantages of liquid embolic embolization of aneurysms.

Original languageEnglish (US)
Pages (from-to)855-860
Number of pages6
JournalNeurosurgery
Volume67
Issue number3
DOIs
StatePublished - Sep 2010

Fingerprint

Aneurysm
Therapeutics
Tantalum
Vertebral Artery
Intracranial Aneurysm
Internal Carotid Artery
Dimethyl Sulfoxide
Publications
Angiography
Randomized Controlled Trials
Onyx HD 500
Injections

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Cite this

Simon, Scott ; Eskioglu, Eric ; Reig, Adam ; Mericle, Robert A. / Endovascular treatment of side wall aneurysms using a liquid embolic agent : A US single-center prospective trial. In: Neurosurgery. 2010 ; Vol. 67, No. 3. pp. 855-860.
@article{e6a9816a4a724dd295f111ad6c4484c9,
title = "Endovascular treatment of side wall aneurysms using a liquid embolic agent: A US single-center prospective trial",
abstract = "Objective: Onyx HD-500 is a liquid embolic agent consisting of ethylene vinyl alcohol copolymer dissolved in dimethylsulfoxide and mixed with tantalum. This viscous embolic agent was designed to treat intracranial side wall aneurysms, but there have been no prospective published series from the United States. From this early experience, we developed several protocol revisions, technical details, and clinical pearls that have not been published for liquid embolic embolization of aneurysms. Clinical presentation: We present our single-center prospective series of patients treated with Onyx HD-500 from a multicenter, randomized, controlled trial. Thirteen patients received Onyx HD-500, and their ages ranged from 43 to 81 years. Twelve patients had aneurysms on the internal carotid artery, and 1 patient had an aneurysm the vertebral artery. Every patient had an immediate postangiographic result with 90{\%} or more occlusion by an independent core laboratory assessment. In 1 patient, the Onyx HD-500 injection was aborted, and the aneurysm was embolized with coils. Eleven of 13 patients (85{\%}) underwent 6-month follow-up angiography that demonstrated persistent durable occlusion with no recanalization. There was 1 complication (8{\%}) and no deaths. Conclusion: This is the only prospective series of intracranial aneurysms treated with Onyx HD-500 in the United States. This is also the first publication that describes detailed procedure techniques, recommended protocol revisions, lessons learned from early complications, clinical pearls, and advantages and disadvantages of liquid embolic embolization of aneurysms.",
author = "Scott Simon and Eric Eskioglu and Adam Reig and Mericle, {Robert A.}",
year = "2010",
month = "9",
doi = "10.1227/01.NEU.0000374772.22745.C3",
language = "English (US)",
volume = "67",
pages = "855--860",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Endovascular treatment of side wall aneurysms using a liquid embolic agent : A US single-center prospective trial. / Simon, Scott; Eskioglu, Eric; Reig, Adam; Mericle, Robert A.

In: Neurosurgery, Vol. 67, No. 3, 09.2010, p. 855-860.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endovascular treatment of side wall aneurysms using a liquid embolic agent

T2 - A US single-center prospective trial

AU - Simon, Scott

AU - Eskioglu, Eric

AU - Reig, Adam

AU - Mericle, Robert A.

PY - 2010/9

Y1 - 2010/9

N2 - Objective: Onyx HD-500 is a liquid embolic agent consisting of ethylene vinyl alcohol copolymer dissolved in dimethylsulfoxide and mixed with tantalum. This viscous embolic agent was designed to treat intracranial side wall aneurysms, but there have been no prospective published series from the United States. From this early experience, we developed several protocol revisions, technical details, and clinical pearls that have not been published for liquid embolic embolization of aneurysms. Clinical presentation: We present our single-center prospective series of patients treated with Onyx HD-500 from a multicenter, randomized, controlled trial. Thirteen patients received Onyx HD-500, and their ages ranged from 43 to 81 years. Twelve patients had aneurysms on the internal carotid artery, and 1 patient had an aneurysm the vertebral artery. Every patient had an immediate postangiographic result with 90% or more occlusion by an independent core laboratory assessment. In 1 patient, the Onyx HD-500 injection was aborted, and the aneurysm was embolized with coils. Eleven of 13 patients (85%) underwent 6-month follow-up angiography that demonstrated persistent durable occlusion with no recanalization. There was 1 complication (8%) and no deaths. Conclusion: This is the only prospective series of intracranial aneurysms treated with Onyx HD-500 in the United States. This is also the first publication that describes detailed procedure techniques, recommended protocol revisions, lessons learned from early complications, clinical pearls, and advantages and disadvantages of liquid embolic embolization of aneurysms.

AB - Objective: Onyx HD-500 is a liquid embolic agent consisting of ethylene vinyl alcohol copolymer dissolved in dimethylsulfoxide and mixed with tantalum. This viscous embolic agent was designed to treat intracranial side wall aneurysms, but there have been no prospective published series from the United States. From this early experience, we developed several protocol revisions, technical details, and clinical pearls that have not been published for liquid embolic embolization of aneurysms. Clinical presentation: We present our single-center prospective series of patients treated with Onyx HD-500 from a multicenter, randomized, controlled trial. Thirteen patients received Onyx HD-500, and their ages ranged from 43 to 81 years. Twelve patients had aneurysms on the internal carotid artery, and 1 patient had an aneurysm the vertebral artery. Every patient had an immediate postangiographic result with 90% or more occlusion by an independent core laboratory assessment. In 1 patient, the Onyx HD-500 injection was aborted, and the aneurysm was embolized with coils. Eleven of 13 patients (85%) underwent 6-month follow-up angiography that demonstrated persistent durable occlusion with no recanalization. There was 1 complication (8%) and no deaths. Conclusion: This is the only prospective series of intracranial aneurysms treated with Onyx HD-500 in the United States. This is also the first publication that describes detailed procedure techniques, recommended protocol revisions, lessons learned from early complications, clinical pearls, and advantages and disadvantages of liquid embolic embolization of aneurysms.

UR - http://www.scopus.com/inward/record.url?scp=77956136946&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956136946&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000374772.22745.C3

DO - 10.1227/01.NEU.0000374772.22745.C3

M3 - Article

VL - 67

SP - 855

EP - 860

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 3

ER -