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CardioVascular and Interventional Radiology

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01-12-2006 | CASE REPORT

Endovascular Embolization of Visceral Artery Aneurysms with Ethylene-vinyl Alcohol (Onyx): A Case Series

Authors: M.J. Bratby, E.D. Lehmann, J. Bottomley, D.O. Kessel, A.A. Nicholson, S.J. McPherson, R.A. Morgan, A.-M. Belli

Published in: CardioVascular and Interventional Radiology | Issue 6/2006

Abstract

We report the application of the liquid embolic agent ethylene-vinyl alcohol (Onyx; MicroTherapeutics, Irvine, CA, USA) in the management of visceral artery aneurysms. The technique and indications for using Onyx are discussed with emphasis on the management of wide-necked aneurysms and maintenance of patency of the parent vessel. None of the cases was considered suitable for stent-grafting or embolization with conventional agents. Two aneurysms of the renal artery bifurcation and one aneurysm of the inferior pancreaticoduodenal artery were treated. Following treatment there was complete exclusion of all aneurysms. There was no evidence of end-organ infarction. Follow-up with intervals up to 6 months has shown sustained aneurysm exclusion. Onyx is known to be effective in the management of intracranial aneurysms. Our experience demonstrates the efficacy and applicability of the use of Onyx in the treatment of complex visceral artery aneurysms.

Molyneux AJ, Cekirge S, Saatci I, et al. (2004) Cerebral Aneurysm Multicenter European Onyx (CAMEO) trial: Results of a prospective observational study in 20 European countries. AJNR Am J Neuroradiol 25:39–51PubMed

Bubul MA, Farrow GA (1992) Renal artery aneurysms. Urology 40:124–126CrossRef

Henke PK, Cardneau JD, Welling TH, et al. (2001) Renal artery aneurysms: A 35 year clinical experience with 252 aneurysms in 168 patients. Ann Surg 234:454–463PubMedCrossRef

Henriksson C, Bjorkerud S, Nilson AE, et al. (1985) Natural history of renal artery aneurysms elucidated by repeat angiography and pathoanatomical studies. Eur Urol 11:244–248PubMed

Smith JN, Hinman F (1967) Intrarenal arterial aneurysms. J Urol 97:990–996PubMed

Uher P, Nyman U, Ivancev K (1995) Aneurysms of the pancreaticoduodenal artery associated with occlusion of the coeliac artery. Abdom Imaging 20:470–473PubMedCrossRef

Coll DP, Lerardi R, Kerstein MD, et al. (1998) Aneurysms of the pancreaticoduodenal arteries: A change in management. Ann Vasc Surg 12:286–291PubMedCrossRef

Sutton D, Lawton G (1973) Coeliac stenosis or occlusion with aneurysm of the collateral supply. Clin Radiol 24:49–53PubMedCrossRef

Kadir S, Athanosoulis CA, Yune HY, et al. (1978) Aneurysms of the pancreaticoduodenal arteries in association with coeliac axis occlusion. Cardiovasc Radiol 25:173–177

10.

Gabelmann A, Gorich J, Merkle EM (2002) Endovascular treatment of visceral artery aneurysms. J Endovasc Ther 9:38–47PubMedCrossRef

11.

Salam TA, Lumsden AB, Martin LG, et al. (1992) Nonoperative management of visceral aneurysms and pseudoaneurysms. Am J Surg 164:215–219PubMedCrossRef

12.

Carr SC, Pearce WH, Vogelzang RL, et al. (1996) Current management of visceral artery aneurysms. Surgery 120:627–633PubMedCrossRef

13.

Kasirajan K, Greenberg RK, Clair D, et al. (2001) Endovascular management of visceral artery aneurysm. J Endovasc Ther 8:150–155PubMedCrossRef

14.

Horwitz MD, Hanbury DC, King CM (2005) Renal artery pseudoaneurysm following partial nephrectomy treated with a stent-graft. Br J Radiol 78:161–163PubMedCrossRef

15.

Bui BT, Oliva VL, Leclerc G (1995) Renal artery aneurysm: Treatment with a percutaneous placement of a stent graft. Radiology 195:181–182PubMed

16.

Seriki DM, Abidia A, Butterfield JS, et al. (2004) Endovascular stent graft: Treatment of pseudoaneurysm of the superior mesenteric artery. Cardiovasc Intervent Radiol 27:271–273PubMedCrossRef

17.

Gandini R, Pipitone V, Konda D, et al. (2005) Endovascular treatment of a giant superior mesenteric artery pseudoaneurysm using a Nitinol stent-graft. Cardiovasc Intervent Radiol 28:102–106PubMedCrossRef

18.

Banga N, Kessel DO, Patel JV, et al. (2005) Endovascular management of arterial conduit pseudoaneurysms following liver transplantation: A report of two cases. Transplantation 79:1763–1765PubMedCrossRef

19.

Kessel D, Wijesinghe LD, Robertson I, et al. (1999) Endovascular stent-grafts for superficial femoral artery disease: Results of 1 year follow up. J Vasc Interv Radiol 10:289–296PubMedCrossRef

20.

Parildar M, Oran I, Memis A (2003) Embolisation of visceral pseudoaneurysms with platinum coils and N-butyl cyanoacrylate. Abdom Imaging 28:36–40PubMedCrossRef

21.

Forester ND, Parry D, Kessel D, et al. (2002). Ischaemic sciatic neuropathy following embolisation of a Type II endoleak. Eur J Vasc Endovasc Surg 23:462–463CrossRef

22.

Akin ED, Perkins E, Ross IB (2003) Surgical handling characteristics of an ethylene vinyl alcohol copolymer compared with N-butyl cyanoacrylate used for embolisation of vessels in an arteriovenous malformation resection model in swine. J Neurosurg 98:366–370PubMedCrossRef

23.

Jahan R, Murayama Y, Gobin YP, et al. (2001) Embolization of arteriovenous malformations with Onyx: Clinicopathological experience in 23 patients. Neurosurgery 48:984–995PubMedCrossRef

24.

Taki W, Yonekawa Y, Iwata H, et al. (1990) A new liquid material for embolization of arteriovenous malformations. AJNR Am J Neuroradiol 11:163–168PubMed

25.

Chaloupka JC, Huddle DC, Alderman J, et al. (1999) A re-examination of the angiotoxicity of superselective injection of DMSO in the swine rete embolization model. AJNR Am J Neuroradiol 20:401–410PubMed

26.

Numan F, Omeroglu A, Kara B, et al. (2004) Embolization of peripheral vascular malformations with ethylene-vinyl alcohol copolymer (Onyx). J Vasc Interv Radiol 15:939–946PubMed

27.

Castaneda F, Goodwin SC, Swischuk JL, et al. (2002) Treatment of pelvic arteriovenous malformations with ethylene-vinyl alcohol co-polymer (Onyx). J Vasc Radiol 13:513–516

28.

Martin ML, Dolmatch BL, Fry PD, et al. (2001) Treatment of type II endoleaks with Onyx. J Vasc Interv Radiol 12:629–632PubMed

29.

Cantasdemir M, Kantarci F, Mihmanli I, et al. (2002) Embolization of profunda femoris artery branch pseudoaneurysm with ethylene-vinyl alcohol copolymer (Onyx). J Vasc Interv Radiol 7:725–728

30.

Warakaulle DR, Aviv RI, Niemann D, et al. (2003) Embolization of spinal dural arteriovenous fistulae with Onyx. Neuroradiology 45:110–112PubMed

31.

Lupattelli T, Abubacker Z, Morgan R, et al. (2003) Embolization of a renal artery aneurysm using ethylene-vinyl alcohol polymer (Onyx). J Endovasc Ther 10:366–370PubMedCrossRef

32.

Saatci I, Cekirge HS, Ciceri EF, et al. (2003) CT and MR imaging findings and their implications in the follow-up of patients with intracranial aneurysms treated with endosaccular occlusion with Onyx. AJNR Am J Neuroradiol 24:567–578PubMed

Title: Endovascular Embolization of Visceral Artery Aneurysms with Ethylene-vinyl Alcohol (Onyx): A Case Series
Authors: M.J. Bratby
E.D. Lehmann
J. Bottomley
D.O. Kessel
A.A. Nicholson
S.J. McPherson
R.A. Morgan
A.-M. Belli
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 6/2006
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-005-0148-3

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Endovascular Embolization of Visceral Artery Aneurysms with Ethylene-vinyl Alcohol (Onyx): A Case Series

Abstract

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