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

Department

neurosurgery

Document Type

Article

Abstract

OBJECTIVE: To assess the utility, technical factors, and complications associated with the use of Onyx (Micro Therapeutics, Inc., Irvine, CA) for preoperative embolization of cranial and spinal tumors. METHODS: We reviewed a prospectively accumulated database for patients in whom Onyx was used for preoperative embolization of cranial and spinal tumors over a 19-month period. The patients' demographic characteristics, tumor type and location, embolic agents used, arteries catheterized, and associated complications were assessed. Specific attention was focused on technical factors associated with the use of Onyx that differed from the use of other commonly used embolic materials. RESULTS: Ten patients (four female and six male; age range, 11-60 yr) underwent preoperative embolization with Onyx before cranial or spinal tumor resection. Tumors included three juvenile nasal angiofibromas, two meningiomas, two hemangioblastomas, two metastases (renal cell and thyroid), and one giant cell tumor. Onyx embolization was performed in 43 vessels over 11 treatment sessions. There were no complications related to the embolization procedures. Deep penetration of the embolic agent into the tumor was documented through preoperative imaging or surgical pathological specimens. CONCLUSION: 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.

Publication Date

2008

Publication Title

Neurosurgery

ISSN

0148-396X

Volume

62

Issue

6

First Page

1204

Last Page

1211

Digital Object Identifier (DOI)

10.1227/01.neu.0000333292.74986.ac

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