Surgical handling characteristics of an ethylene vinyl alcohol copolymer compared with N-butyl cyanoacrylate used for embolization of vessels in an arteriovenous malformation resection model in swine

Author:

Akin Eric D.,Perkins Eddie,Ross Ian B.

Abstract

Object. There have been significant improvements in neurovascular technology and implants over the past decade. One such material, N-butyl cyanoacrylate (NBCA), is now commercially available for cerebral arteriovenous malformation (AVM) embolization in the US. An ethylene vinyl alcohol copolymer preparation, Onyx, which is currently being evaluated, is approved for use outside North America. Although reports indicate that Onyx may be superior to NBCA from an endovascular perspective, little information exists about its surgical handling characteristics. The purpose of this study was to compare the surgical handling characteristics of Onyx-treated vessels with those of NBCA-embolized vessels in an AVM resection model. Methods. Fourteen pigs (two groups of seven) were anesthetized. A femoral artery was cannulated, followed by selective catheterization of the ascending pharyngeal arteries. Nidal rete mirabile (RM) embolizations were performed using either 6% Onyx or 20% NBCA. After angiographically confirmed obliteration of flow in the right RM, microsurgical resection of this structure was performed. Surgical handling characteristics of the embolized RM were rated on a scale of 1 to 5 and blood loss was recorded. Different surgeons performed the embolizations and resections. The surgeon who performed resections was blinded to the embolization agent used, and the data analysis was also performed in a blinded fashion. The surgical handling scores were superior (p < 0.05) in the Onyx-treated group. Although there was also less blood loss in this group, the difference was not significant. Subjectively, the surgeon who performed the resections believed that Onyx was softer and handled better than NBCA. Conclusions. Onyx, which may offer endovascular advantages, also seems to provide benefits for the surgeon.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Reference23 articles.

Cited by 68 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Real-Time MRI Monitoring of Liquid Embolic Agent (Onyx) Injection in a Swine Arteriovenous Malformation Model;Brain Sciences;2023-06-06

2. Intracranial Embolization Procedures;Handbook of Cerebrovascular Disease and Neurointerventional Technique;2023

3. Arteriovenous Malformations of the Brain;Current Clinical Neurology;2022

4. Transarterial embolization;Cerebral Dural Arteriovenous Fistulas;2021

5. Single institutional experience of peripheral applications of a liquid embolic agent: Ethylene Vinyl Alcohol Copolymer;CVIR Endovascular;2020-08-02

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