Introduction Although AVMs are rare among pediatric population, nearly half of spontaneous intracranial hemorrhages in children are due to these malformations. Onyx, as an FDA approved embolizant for adults, has limited studies regarding its safety and efficacy among children. Here, we evaluate the safety and efficacy of Onyx embolization in pediatric neurointerventional procedures.
Methods In this study, all pediatric Onyx embolization of intracranial AVM cases are evaluated over a period of 10 years. Medical record and radiology imaging were reviewed for each patient regarding demographic data, clinical presentations, embolization procedure and related complications.
Results Seventy-two patients (female=26 (36%)) with intracranial AVMs underwent total of 122 embolization procedures. Age of patients ranged between 1 month to 17 years with the mean of 10.2 years. Forty-four patients underwent a single embolization procedure and staged embolization was required for the remaining 28 patients prior to definitive treatment. Onyx embolization resulted in complete occlusion of the AVM in 10 patients (14%). A total of 66 patients underwent subsequent surgical treatment.
Overall 13 complications occurred in total of 122 Onyx embolizations (10.6%) which resulted in 7 transient neurological deficits and 6 clinically silent complications (Table 1). None of the complications resulted in mortality or permanent morbidity. No significant demographic characteristic differences observed in patients with or without complications.
Conclusion In this study we propose the safe and effective utilization of Onyx for embolization of pediatric cerebral AVMs. The relative low rate of complications (10.6%) along with no mortality or permanent morbidity, suggests the safe utilization of Onyx as a preoperative or primary embolization treatment of pediatric intracranial AVMs. However, specific attention should be considered for its indications and technical limitations according to the broad spectrum of complications.
Disclosures T. Shokuhfar: None. A. Al-Smadi: None. S. Ansari: None. M. Hurley: None. M. Potts: None. B. Jahromi: None. A. Shaibani: None.