Improved Results for Treatment of Persistent type 2 Endoleak after Endovascular Aneurysm Repair: Onyx Glue Embolization
June 28, 2013 by larryhbern
Improved Results for Treatment of Persistent type 2 Endoleak after Endovascular Aneurysm Repair: Onyx Glue Embolization
Writer, Curator: Larry H Bernstein, MD, FCAP
and
Curator: Aviva Lev-Ari, PhD, RN
Onyx is comprised of
EVOH (ethylene vinyl alcohol) copolymer dissolved in
DMSO (dimethyl sulfoxide), and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy.
A DMSO compatible delivery micro catheter that is indicated for use in the neuro vasculature (e.g. Marathon™, Rebar® or UltraFlow™ HPC catheters) is used to access the embolization site.
Onyx is available in two product formulations, Onyx 18 (6% EVOH) and Onyx 34 (8% EVOH).
Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair.
Abularrage CJ, Patel VI, Conrad MF, Schneider EB, Cambria RP, Kwolek CJ
Persistent type 2 (PT2) endoleaks (present ≥ 6 months) after endovascular aneurysm repair are associated with adverse outcomes, and
- selective secondary intervention is indicated in those patients with an expanding aneurysm sac.
This study evaluated the outcomes of secondary intervention for PT2.
From 1999 to 2007, 136 patients who underwent endovascular aneurysm repair developed PT2 and comprised the study cohort. Primary end points included
- PT2 resolution (secondary interventional success) and
- survival
both were evaluated using multiple logistic regression and Kaplan-Meier analyses
Fifty-one patients underwent a total of 68 secondary interventions for PT2 with expanding aneurysm sacs
- with a median postsecondary interventional follow-up of 13.7 months.
Secondary interventions included
- 20 inferior mesenteric artery coil embolizations,
- 17 Onyx glue embolizations,
- 11 aneurysm sac coil embolizations,
- 10 non-Onyx glue embolizations,
- 7 lumbar artery coil embolizations,
- 2 open lumbar ligations, and 1 graft explant.
The overall secondary interventional success rate was 43% (29 of 68). Onyx glue embolization was associated with
- a greater success rate when used as the initial secondary intervention (odds ratio, 59.61; 95% confidence interval, 4.78-742.73; P < .001).
There was no difference in success between the different techniques when multiple secondary interventions were required. Five-year survival was 72% ± 0.08% and
- was unrelated to any of the secondary interventional techniques.
Secondary intervention for PT2 is associated with success in less than half of all cases. Onyx glue embolization was associated with greater long-term success
- when used as the initial secondary intervention.
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I actually consider this amazing blog , âSAME SCIENTIFIC IMPACT: Scientific Publishing –
Open Journals vs. Subscription-based « Pharmaceutical Intelligenceâ, very compelling plus the blog post ended up being a good read.
Many thanks,Annette
I actually consider this amazing blog , âSAME SCIENTIFIC IMPACT: Scientific Publishing –
Open Journals vs. Subscription-based « Pharmaceutical Intelligenceâ, very compelling plus the blog post ended up being a good read.
Many thanks,Annette