Title
Microsurgical removal of Onyx HD-500 from an aneurysm for relief of brainstem compression: case reportMicrosurgical removal of Onyx HD-500 from an aneurysm for relief of brainstem compression: case report
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Antwerp Surgical Training, Anatomy and Research Centre (ASTARC)
Translational Neurosciences (TNW)
Faculteit Geneeskunde
Publication type
article
Publication
Charlottesville, Va,
Subject
Human medicine
Source (journal)
Journal of neurosurgery. - Charlottesville, Va, 1944, currens
Volume/pages
113(2010):4, p. 770-773
ISSN
0022-3085
1933-0693
ISI
000282244700018
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
The authors report the successful removal of Onyx HD-500 from an aneurysm sac by means of ultrasonic aspiration. This 46-year-old woman presented with progressive spasms of her left arm and leg due to mass effect and compression on the right cerebral peduncle 5 years after endovascular treatment of an unruptured giant posterior communicating artery aneurysm with Onyx HD-500. No filling of the aneurysm was detected on angiography. The patient underwent a right pterional craniotomy and the aneurysm was opened to remove the Onyx mass. However, contrary to expectations, the aneurysm was still patent, filling with blood between the Onyx mass and the aneurysm wall. Under temporary clipping of the carotid artery, the Onyx mass within the aneurysm was removed in a piecemeal fashion using an ultrasonic aspirator and the aneurysm was then successfully clipped. The patient experienced significant improvement of the spasm after surgery. Angiography showed complete occlusion of the posterior communicating artery aneurysm. It is rarely necessary to remove embolization material such as Onyx HD-500, and little is known about the most appropriate surgical technique. This case report demonstrates that removal can be safely accomplished by means of ultrasonic aspiration.
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