In Vitro Quantification of the Radiopacity of Onyx during Embolization / 신경중재치료의학

PURPOSE: Onyx has been successfully applied in the treatment of various neurovascular lesions. However, some experience is required to get accustomed to its unpredictable fluoroscopic visibility during injection. This in vitro study aimed to evaluate the characteristics of radiopacity change in a simulated embolization procedure. MATERIALS AND METHODS: Using a bench-top Onyx injection experiment simulating a typical brain arteriovenous malformation embolization, nine cycles of casting modes (continuous injection) and plugging modes (injection with intermittent pauses) were performed. Radiodensity of Onyx droplets collected from the microcatheter tip and the distal head portion of the microcatheter were measured as time lapsed. Distribution of droplet radiodensity (radiodensity) and distribution of radiographic grade (grade) were analyzed and compared by repeated measurements. RESULTS: Within-group analysis revealed no significant radiodensity change with time (P>0.05). The radiodensity was significantly higher in the casting mode than in the plugging mode (P<0.01). The lateral radiograph of the microcatheter showed higher radiopacity (P<0.01) and better evenness (P<0.01) in the casting mode than in the plugging mode. A significant difference in microcatheter attenuation (both radiographic grade mean and SD; P<0.01) was noted between the two modes. Radiodensity had a significant influence on the radiopacity and radiopacity evenness of the microcatheter. CONCLUSION: The radiopacity of the Onyx can vary significantly over time because of early precipitation of tantalum powder. Radiopacity decreased significantly during plugging modes, characterized by pauses between injections.

Endovascular Treatment of Intracranial AVM / 대한뇌혈관학회지

Since 1983, we have experienced endovascular treatment of intracranial AVMs.2)3) Superselective catheterization of feeding artery, embolization or feeding artery occlusion of the cerebral AVMs have been performed for 73 cases in 134 sessions. Endovascular treatment of intracranial AVMs such as embolization or feeding artery occlusion have been performed for 57 cases of AVMs in 95 sessions. In each time, endovascular approach was performed for two to five feeding arteries, so more than 300 feeding arteries were catheterized by microcatheters or balloon catheters. In this report, we present our experiences of endovascular treatment of intracranial AVMs and discuss embolic materials and the role of endovascular treatment of intracranial. AVMs.