Embolization alone DOES NOT obliterate an AVM

Hello fellow survivors, having been here for over a year now and reading many posts regarding embolizations, I think it would be helpful to define what the procedure actually means. As in my case, embolizations can definitely treat avm ‘symptoms’ by redirecting blood flow. After 4 embo’s my left side weakness and hemianopsia were greatly improved!:slight_smile: I do know, however, that my avm is still there and is NOT trying to obliterate like it would had I had SRS. The initial reasoning for my embolizations was to reduce blood flow to the avm so a potential crainiotomy would mean less blood loss. Even if I had chosen to pursue radiation with Cyberknife, they would still have to treat(radiate) the embolized portions of my avm, b/c it is still there, just loaded with ONYX. How long the ONYX lasts in the body, I don’t know? I do know that a company named ev3 manufactures ONYX, and they are now part of Covidien thru acquisition. Perhaps,maybe, some avms are so small or even AV Fistulas, that surgeons believe completely obstructing flow through these vessels will cause obliteration? My ultimate question is…"How long does ONYX, or other embolic agents, continue to be effective at blocking blood supply? Thought this might generate an interesting discussion because even though I have had 4 successful embolizations, my avm is STILL inoperable.(crainiotomy, SRS) -GK

Greg, as far as I know you are correct about the ebmbolizations. They do not obliterate the AVM just "stop " blood flow to the AVM. Coils slow down the blood flow so they can go back in and use the onxy on fast flowing veins/arteries. My husband had 5 embos and his crani on Dec 28th (he is in rehab now) even though the embo's had blocked 60% of the blood flow he still lost 4 1/2 pints of blood in surgery. Cant even imagine the outcome if they had not done that.

I am going to forward your question of how long onyx last in the body to our surgeon he always replies to questions

Sending positive energy your way

Karen, thanks for the response:) I’m willing to bet that the ONYX question is one that has many differing responses from different docs. I would love to see a clinical trial from the manufacturer, but I am just happy that it has served its purpose so far! So glad ur husband is recovering from such a big operation! Take care -GK

Hey Greg,
I was taking a look at some of your posts. Thanks for posting this. I had SRS in July 2010 and then an embolization two months ago after my 4th hemorrhage. I admit I do have trouble fully understanding things sometimes now, but your explanation of this led to me having an “aha” moment. Much appreciated. I wish you all the best.

I was re-thinking my post here after reading more and more stories of other ONYX patients, but then I found this article written by a Mayo and Brown University MD..... http://www.ajnr.org/content/30/1/107.full -GK

Thanks for sharing the article, Greg. It has given me a lot to think about.

Hi, Greg, to complicate the issue further, there is a rebuttal to the article: http://www.ajnr.org/content/30/5/e67.full

Hi dancermom, I read that too. I know there has been a debate, but I tend to side with the U.S. surgeons. Especially ones from the likes of Mayo. The original findings that were pro-obliteration via embo, came from a group of Greece docs. Also, I have seen an Indian surgeon on Youtube claim total obliteration from embo alone. -GK

Greg, you have an interesting question there that I sure can not answer so I am going to ask you an unrelated one instead....Did they put you to sleep during the embolizations or just sedate you? Did you feel better after each embolization?

Lea, welcome to the group. Yes u are put to sleep for the actual embolization, but the procedure starts as an angiogram with only sedation. Some Dr.'s may keep u awake longer to test certain vessels in the avm that they want to occlude. They can inject a substance that temporarily numbs those vessels and ensure that there are no new deficits before they use something as permanent as Onyx. Yes, I improved after each of my 4 embos. So much so that the only 'symptom' I still live with is a slight visual field cut in the left upper quadrant of each eye. Before the embos my entire left side visual field was affected. All my left side weakness issues improved as well. -GK

Hi Greg - I kind of didn’t have a clue what I was doing, but I’ll email my neuro.'s assistant regarding my embos.

Hi Greg - I talked with my nuerosurgeon’s assistant today; she said that the embo. helps to occlude the AVM by stopping the bleeding.

I had a crainiectomy vs. a craniotomy - still have to Google that since I’m unsure of the difference, but it’s my understanding with a bleed, the AVM is removed; I had a bleed so I’m guessing that the craniectomy required further embolizaton??? Thank goodness for Wikipedia :slight_smile:

I hope that this little bit helps to clear up the muddy water, somewhat anyway.

Hi Greg! Sorry for pulling out this thread but I think it's a very interesting question. In my case, I had a Small left parien AVM, which as been fully treat with embolization (only 1 session). Now, after almost 7 years after the procedure, i Done a MRI and the doctors have a doubt about the full embolized. In the next days I will do a angiogram and if necessary an new embolization.
Regard of this,I think full embolization (with onyx or any other glue) only can be atempted with smal/medium sized AVM.

Acording to this study, the chance of recanalization of an AVM full embolized it's about 1% after 8 years of treatment. So I think, it can be say that its a reliable treatment.
Best regards


Thank you for posting this study, Scarfish. Very interesting read. I know there are different opinions from various groups. I am doing extremely well, almost 4 years since my embos began. I fall into the partially embolised, declined further treatment category. Thanks again for sharing. -GK