Use of intracranial stenting to secure unstable liquid embolic casts in wide-neck sidewall intracranial aneurysms.

Scott D. Simon, Demetrius K. Lopes, Robert A. Mericle

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

BACKGROUND: Onyx HD 500 (eV3, Irvine, CA) is a high-viscosity liquid embolic agent that has recently been approved in the United States as a humanitarian use device for the treatment of wide-neck sidewall intracranial aneurysms. Preliminary evidence suggest that liquid embolic agents can provide improved angiographic results with a lower incidence of recanalization compared to coil embolization. OBJECTIVE: To report unstable Onyx casts and how to deal with them. METHODS: We report 4 cases of intracranial aneurysms treated with Onyx HD 500 in which, after the aneurysm was successfully obliterated, the Onyx cast was noted to have 1 of 2 types of embolic cast instability. In all 4 cases, an intracranial stent or vascular reconstruction device (VRD) was placed across the Onyx cast at the aneurysm orifice and the cast was stabilized. CONCLUSION: This series is the first published description of Onyx HD 500 aneurysm cast instability. It is also the first report of using a stent or vascular reconstruction device rescue technique to secure an unstable Onyx cast and represents a new indication for these devices.

Original languageEnglish (US)
Pages (from-to)92-97; discussion 97-98
JournalNeurosurgery
Volume66
Issue number3 Suppl Operative
StatePublished - Mar 2010

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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