• Guobiao Liang, Zhiqing Li, Xu Gao, Haifeng Zhang, Jun Lin, Shize Feng, and Xuedong Wei.
• Department of Neurosurgery, General Hospital of Shenyang Military Region, Shenyang, Liaoning, PR China. liangguobiao6708@163.com
• Eur J Radiol. 2012 Aug 1;81(8):1858-62.

Background And PurposeInternal carotid artery (ICA) large or giant saccular aneurysms is challenging for endovascular coil embolization and surgical clipping with a high recanalization and rebleeding rate. We report our results using Onyx in the endovascular treatment of ICA large or giant saccular aneurysms.MethodsDuring 2008-2010, 5 patients with 5 large or giant saccular aneurysms in ICA were treated with a liquid embolic agent (Onyx; Micro Therapeutics, Irvine, CA). One aneurysm was small (<10mm), 2 were large (≥10mm, <25mm) and 2 were giant saccular aneurysms (≥25mm). Of 3 female and 2 male patients, 3 were incidental and 2 had bleeding. Selective embolization was performed with Onyx alone or a combination with coils. Clinical and anatomic outcomes were assessed with the Modified Glasgow Outcome Scale and follow-up angiography was performed at 4-21 months (mean 12.2 months).ResultsComplete aneurysm occlusion was obtained in all of the aneurysms on immediate control angiogram. There was not any procedure-related complication. No recanalization was observed at the follow- up periods. There were 2 ICA occlusions in giant ICA aneurysms. The 5 patients were all clinically asymptomatic at follow-up.ConclusionEndovascular embolization with Onyx is a useful treatment for ICA large or giant aneurysms, which is unsuitable for coiling or surgical treatment.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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