Purpose: The aim of this study was to test the feasibility and efficacy of the treatment of wide-necked and giant intracranial aneurysms with a new liquid embolic agent.
Materials and methods: During injection of Onyx, an occlusion balloon with or without an intracranial stent was inflated in the parent artery. Sixty-seven patients harboring 72 intracranial aneurysms, most of which being giant or wide-necked, were successfully treated with this technique.
Results: Seventy of 72 aneurysms were internal carotid artery aneurysms. Of these, 37 were ophthalmic (53%), 18 were cavernous (26%) and 15 were petrous (21%) internal carotid artery aneurysms. One patient had 2 aneurysms located at the basilar and superior cerebellar arteries. Fifty-three aneurysms were treated with the balloon remodelling technique and 19 were treated with the use of an intracranial stent. Recanalisation was found in 8 of 15 giant aneurysms which were treated with the balloon remodelling technique and 3 of these underwent a second treatment in which stents were used. Mortality occurred in 3 patients.
Conclusion: Onyx embolisation with balloon or stent remodelling technique is a feasible and effective method in the treatment of high-risk giant or wide-necked intracranial aneurysms which are difficult to treat with other endovascular or microsurgical techniques.