Embolic agent | Advantages | Disadvantages |
Particles | ||
Various manufacturers | Consistent penetration | Requires delivery and visualization medium (typically contrast and ± normal saline) |
Multiple size options | Delayed recanalization may occur | |
Inexpensive | May require increased fluoroscopy and procedure times compared with nBCA | |
Injection not painful | ||
Aspherical type (contour PVA) possibly induces less necrosis then spherical ones | ||
Liquid agents | ||
TRUFILL n-BCA | Instant permanent occlusion | Inconsistent penetration |
Strategic distal penetration is possible | Shorter working times can be a disadvantage, requiring vigilance and experience | |
Short working time can be an advantage | Possible catheter retention Expensive | |
Onyx | Permanent occlusion | Inconsistent penetration |
Longer working times | CT artifacts (usually minor in MMA embolization) | |
Strategic distal penetration is possible | May require increased fluoroscopy and procedure times compared with nBCA | |
Generally excellent radio-opacity | Injection may be painful | |
Possible catheter retention | ||
Expensive | ||
Coils | ||
Pushable fibercoils | Inexpensive | Not retrievable |
Highly thrombogenic | Require use of 0.021 type delivery microcatheters | |
Detachable | Retrievable | Expensive compared with pushable coils |
Compatible with 0.017 type delivery microcatheters |
MMA, middle meningeal artery; nBCA, n-butyl cyanoacrylate.