000 03020nam a22003857a 4500
008 221213s20222022 xxu||||| |||| 00| 0 eng d
022 _a1878-8750
024 _a10.1016/j.wneu.2022.11.058 [doi]
024 _aS1878-8750(22)01610-2 [pii]
040 _aOvid MEDLINE(R)
099 _a36396047
245 _aThe era of Onyx embolization: A systematic and literature review of preoperative embolization before stereotactic radiosurgery for the management of cerebral arteriovenous malformations. [Review]
251 _aWorld Neurosurgery. 2022 Nov 14
252 _aWorld Neurosurg. 2022 Nov 14
253 _aWorld neurosurgery
260 _c2022
260 _fFY2023
260 _p2022 Nov 14
265 _saheadofprint
266 _d2022-12-13
520 _aCONCLUSION: Onyx (ethylene vinyl-alcohol (EVOH) copolymer dissolved in dimethyl sulfoxide (DMSO) and suspended in micronized tantalum powder) has been increasingly used for the embolization of intracranial AVMs with increased success regarding its ease of use from a technical standpoint and performs similarly to other embolysate materials. Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.
520 _aINTRODUCTION: The current treatment paradigm for intracranial arteriovenous malformations (AVMs) focuses on reducing the risk of intracranial hemorrhage using various therapeutic means including embolization, stereotactic radiosurgery (SRS), and microsurgical resection. To improve AVM obliteration rates with SRS, pre-radiosurgical embolization has been trialed in a number of studies to reduce the volume of the AVM nidus prior to radiosurgery. This study aimed to review the efficacy of pre-radiosurgical embolization in the pre-Onyx era compared to the current Onyx era.
520 _aMETHODS: A systematic review was performed using PubMed to identify studies with 20 or more AVM patients, embolization material, and obliteration rates for both E+SRS (embolization + stereotactic radiosurgery) and SRS only groups.
520 _aRESULTS: Seventeen articles consisting of 1133 eligible patients were included in this study. 914 (80.7%) patients underwent embolization prior to SRS. Onyx was used as the embolysate in 340 (37.2%) patients in the E+SRS cohorts. Mean obliteration rate for the embolized cohort was 46.9% versus 46.5% in the SRS only cohort. When comparing obliteration rates based on embolysate material, obliteration rates with Onyx+SRS were 42.1% and 50.0% in the non-Onyx embolysate + SRS cohort.
546 _aEnglish
650 _aIN PROCESS -- NOT YET INDEXED
651 _aMedStar Washington Hospital Center
656 _aNeurosurgery
657 _aJournal Article
657 _aReview
700 _aArmonda, Rocco A
_bMWHC
790 _aAmpie L, Armonda RA, Gupta HR, Kellogg RT, Letchuman V, Mittal AM, Park MS, Raper D, Sheehan JP
856 _uhttps://dx.doi.org/10.1016/j.wneu.2022.11.058
_zhttps://dx.doi.org/10.1016/j.wneu.2022.11.058
942 _cART
_dArticle
999 _c50
_d50