Background: Endovascular embolization is one of the main modalities in the treatment of ruptured intracranial arteriovenous malformations (AVMs). The endovascular approach to AVM using different embolizing agents is a well-established treatment strategy.
Objective: This study aimed at evaluating of the efficacy of endovascular embolization of AVM using detachable-tip microcatheters and Onyx 18®.
Patients and methods: This retrospective study was conducted at the Department of Neurosurgery Zagazig University on 40 patients suffering from ruptured AVMs and underwent procedural intervention during the period from 2018 to 2020 for evaluation of the efficacy of endovascular embolization of AVM using detachable-tip microcatheters and Onyx 18®. The interventional procedures for treatment of cerebral AVMs included the following procedures either in solitary or combined fashions; endovascular embolization and stereotactic radiosurgery.
Results: AVM patients were 28 males (70.0%) and 12 females (30.0%), the mean age of all patients was 27± 0.4 years; all of them presented with spontaneous intracranial hemorrhage, 40.0% had associated neurological problem. About 65.0% of patients presented with bad grade by modified Rankin Scale (mRS). MVA were graded according to Buffalo score ranged from 1 to 4 with median 2 and about 47.5 % of patients had Buffalo 2. While Spetzler-Martin's grading ranged from 2 to 5 with median 3 and about 47.5% of patients had SMG 3. Obliteration percent was 90 ranged from 70% to 100% with median 90%.
Conclusion: The application of Onyx in ruptured intracranial arteriovenous malformations is flexible, effective and safe. Onyx provides the opportunity to adjust the treatment to each individual patient.