Table 1

Summary of embolic agents21 47–51

Embolic agentAdvantagesDisadvantages
Various manufacturersConsistent penetrationRequires delivery and visualization medium (typically contrast and ± normal saline)
Multiple size optionsDelayed recanalization may occur
InexpensiveMay 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-BCAInstant permanent occlusionInconsistent penetration
Strategic distal penetration is possibleShorter working times can be a disadvantage, requiring vigilance and experience
Short working time can be an advantagePossible catheter retention
OnyxPermanent occlusionInconsistent penetration
Longer working timesCT artifacts (usually minor in MMA embolization)
Strategic distal penetration is possibleMay require increased fluoroscopy and procedure times compared with nBCA
Generally excellent radio-opacityInjection may be painful
Possible catheter retention
Pushable fibercoilsInexpensiveNot retrievable
Highly thrombogenicRequire use of 0.021 type delivery microcatheters
DetachableRetrievableExpensive compared with pushable coils
Compatible with 0.017 type delivery microcatheters
  • MMA, middle meningeal artery; nBCA, n-butyl cyanoacrylate.