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March 28 - New Treatment Provides Less Invasive Option for Brain Abnormalities

Neurosurgeons at The Ohio State University Medical Center are using a nontraditional substance to prevent ruptures and strokes in patients with brain abnormalities. A catheter feeds the black, lava-like substance, known as Onyx, through an artery into the brain to a tangle of vessels, known as an arterio-venous malformation (AVM), that are responsible for strokes. The thick substance has chemical properties that clog and shrink the tiny clusters enough to reduce blood loss before or after surgery. However, the need for surgery is often reduced once the mass is stabilized.

“By breaking the AVM down and decreasing the blood flow, it’s not only much safer, but less invasive for the patient. So, if I can treat someone’s abnormality without opening up their head, they can leave the hospital much faster and get back to work much quicker,” says Louis Caragine, MD, a neurosurgeon and director of endovascular neurosurgery at Ohio State’s Medical Center.

According to Caragine, procedures are much safer using the substance because it reduces the blood going through the damaged part of the brain. Normally, blood flows through the arteries to capillaries, which create a junction between the arteries and veins. The abnormal mass disrupts the blood flow of the capillaries and, without capillaries to slow the blood flow, high blood pressure flowing into the veins causes them to widen and sometimes rupture and bleed. In the past, if an abnormality in the brain was too big, few treatment options existed. Surgeries were especially risky due to increased blood loss and potential brain tissue damage. Now, by shrinking them in stages, doctors can gradually make the mass small enough to treat with focused beam radiation.

Caragine says a future study will help determine if the substance will be used for the treatment of aneurysms in the future. Patients may not know they have a brain abnormality until it hemorrhages and causes a stroke. There is an additional 4% risk of bleeding for the patient per year.

“A patient living 10 years with an AVM can experience bleeding over time. As a result, there’s a 40% chance that an AVM will rupture,” adds Caragine.

Onyx was approved by the Food and Drug Administration in 2007 and is manufactured by Micro Therapeutics, Inc.

Source: The Ohio State University Medical Center

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