New Liquid Treatment for Brain Aneurysms: Liquid Hardens on Contact, Sealing off Blood Flow

Patients with brain aneurysms now have access to a novel new treatment option. William Holloway, MD, a neurointerventional radiologist at Saint Luke’s Hospital (Kansas City, Mo.), is one of only a few physicians in the nation treating patients using a new FDA-approved liquid embolic system for treating wide-necked brain aneurysms. The first procedure was performed at Saint Luke’s on March 15. “A wide-necked brain aneurysm occurs in about 25 percent of patients with brain aneurysms,” said Dr. Holloway. “Some brain aneurysms can be difficult to treat with traditional surgery, because of their location deep within the brain. With Onyx® HD 500, we are able to use a minimally invasive endovascular procedure to treat the aneurysm from within the blood vessel.” The Onyx material is a liquid polymer that is injected in liquid form through a small micro-catheter to the affected area of the brain. The glue-like substance begins to solidify almost immediately, sealing off blood flow to the aneurysm and reducing the pressure and likelihood of rupture. Initial clinical results are encouraging, said Dr. Holloway. “The potential benefit of the liquid embolic system may be the complete blockage of the blood supply to the aneurysm. This would make a recurrence of the aneurysm less likely than seen with other endovascular treatment methods. It may also help to correct or lessen some symptoms from larger aneurysms that can compress the nerves that control vision or swallowing.” Other treatment options include navigating a small catheter from the groin to the brain aneurysm and filling the aneurysm with metallic coils, forming a blockage in the aneurysm. However, there is the possibility that the coils will compact over time, resulting in a recurrence of the aneurysm. In addition, some wide-necked aneurysms have such a large opening that the coils may not stay inside the aneurysm sac. By filling the aneurysm sac or pocket with the Onyx liquid, which solidifies in approximately five minutes, blood flow into the aneurysm is blocked, preventing the aneurysm from rupturing or increasing in size. The release of the liquid treatment was preceded by a lengthy period of education and training for a small group of leading U.S. neurovascular specialists. Saint Luke’s Hospital is one of about 25 hospitals in the United States to perform this procedure as an alternative to conventional surgery. Dr. Holloway works collaboratively with his surgical colleagues, including neurosurgeon Paul Camarata, MD, at Saint Luke’s Hospital to help diagnose and determine the best treatment for diseases of the brain and spinal cord. Treatments for aneurysm may include traditional surgery or endovascular procedures like the Onyx® HD 500 liquid treatment (ev3 Endovascular, Inc., Plymouth, MN). The Onyx® HD 500 liquid treatment has been FDA approved under a Humanitarian Device Exemption from the U.S. Food & Drug Administration, which allows physicians to use the liquid to treat a disease or condition that affects fewer than 4,000 individuals in the United States per year and for which no comparable device is available. Certain treatment criteria apply.