Ethylene Vinyl Alcohol Copolymer (Onyx) Embolization for Acute Hemorrhage: A Systematic Review of Peripheral Applications

Kolber, M.; Shukla, Pratik A.; Kumar, Abhishek; Silberzweig, James E.

doi:10.1016/j.jvir.2015.02.025

Cited by 35 publications

(32 citation statements)

References 36 publications

(84 reference statements)

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“…In accordance with the literature, this series confirms that Onyx ® is both effective and safe in treating peripheral lesions, which strengthens the possibility to use it in different anatomical sites. As already highlighted by various authors, Onyx ® can be used for the embolization of all peripheral hemorrhages (3,16), aneurysms, type II endoleaks (17), hemoptysis (18), cutaneous AVMs (6), angiomyolipoma (19). Besides, in our study, 6 patients (12%) underwent preoperative portal embolization using Onyx ® without any complication, a fact that has yet never been described in the literature.…”

Section: Discussionsupporting

confidence: 62%

“…It is categorized as a non-absorbable, non-adhesive, permanent liquid embolic agent that may be used off-label for both small and large vessels (2). These features making EVOH copolymer effective in treating cerebrovascular lesions may benefit peripheral applications, which explain why its use is becoming more widespread among interventional radiologists in the treatment of peripheral lesions (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). However, Onyx  is still perceived by some interventional radiologists as an expensive and complex embolic agent.…”

Section: Introductionmentioning

confidence: 99%

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Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study

Ne¹,

Chevallier²,

Falvo³

et al. 2018

Quant. Imaging Med. Surg.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study

Ne¹,

Chevallier²,

Falvo³

et al. 2018

Quant. Imaging Med. Surg.

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“…Embolic microspheres are approved for the treatment of AVMs. More recently, liquid embolics, particularly non-adhesive ethylene vinyl alcohol (EVOH) or Onyx ® , has been investigated as an improved option [17]. …”

Section: Introductionmentioning

confidence: 99%

Polymeric materials for embolic and chemoembolic applications

Poursaid

Jensen

Huo

et al. 2016

Journal of Controlled Release

117

103

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Percutaneous transcatheter embolization procedures involve the selective occlusion of blood vessels. Occlusive agents, referred to as embolics, vary in material characteristics including chemical composition, mechanical properties, and the ability to concurrently deliver drugs. Commercially available polymeric embolics range from gelatin foam to synthetic polymers such as poly(vinyl alcohol). Current systems under investigation include tunable, bioresorbable microspheres composed of chitosan or poly(ethylene glycol) derivatives, in situ gelling liquid embolics with improved safety profiles, and radiopaque embolics that are trackable in vivo. This article reviews commercially available materials used for embolization as well as polymeric materials that are under investigation.

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“…The ability of EVOH to conform to vessel/duct shape and its high fluoroscopic visibility are key advantages. 19 However, due to slow polymerization, it had to be combined with cyanoacrylate or AVP to overcome uncontrolled run-off, which was a substantial disadvantage.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Embolization of Biliary Leaks: A Systematic Interdisciplinary Review and Proposal for a New Classification

Schmitz

Mutignani

Neumann

et al. 2020

Digestive Disease Interventions

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Objectives Biliary leak can be treated by percutaneous biliary embolization. The aim of this systematic interdisciplinary review was to analyze available reports on percutaneous embolization of biliary leak. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach to perform literature database search. The following terms were systematically analyzed: type of embolic agent, success rates, embolization-related adverse events, cause of biliary leak, fistula connection type, anatomic bile duct variants, and access routes. Results Of 713 publications identified, 45 reports with 101 patients were included. Six temporary and 4 permanent embolic agents were used in 55/101 (54.5%) and 46/101 (45.5%) patients; combined in 18/101 patients (17.8%). Bile leak was successfully embolized in 97/101 (96.0%) patients, in 48/101 (47.5%) patients after repeated procedures with the same agent, and in 4/101 (3.9%) patients after a failed embolization with other agents: isolated bile duct fistula (n = 2), intrahepatic fistula after liver resection, and biliary-bronchial fistula. Five types of biliary leak were associated with the following success rates: (A) common bile duct (CBD) or cystic duct: 4/4 (100%); (B) intrahepatic bile duct (IHBD), communicating with CBD: 16/18 (88.9%); (C) isolated IHBD: 49/51 (96%); (D) CBD or cystic duct, bile duct system (BDS) not accessible by endoscopic retrograde cholangiopancreatography (ERCP): 7/7 (100%); and (E) IHBD, communicating with CBD, BDS not accessible by ERCP: 9/9 (100%). Conclusions Embolization was highly successful without clear preference for one embolic agent. A new classification of biliary leak is proposed to direct nonsurgical treatments.

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Ethylene Vinyl Alcohol Copolymer (Onyx) Embolization for Acute Hemorrhage: A Systematic Review of Peripheral Applications

Cited by 35 publications

References 36 publications

Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study

Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study

Polymeric materials for embolic and chemoembolic applications

Percutaneous Embolization of Biliary Leaks: A Systematic Interdisciplinary Review and Proposal for a New Classification

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