'Black Tar' Liquid Gold When It Comes To Brain Surgeries

'Black Tar' Liquid Gold When It Comes To Brain Surgeries

The following is a transcript of a report by medical editor Marilyn Brooks that first aired March 31, 2008, on WTAE Channel 4 Action News at 5 p.m.

A substance that looks like black tar is proving to be liquid gold when it comes to certain brain surgeries.


Neurosurgeons are using Onyx to prevent ruptures and strokes in abnormal vessels in the brain.

Onyx yields some pretty remarkable results when doctors inject it into the brain to treat arteriovenous malformations or AVMs.

Arteriovenous malformations are a tangled coil of arteries and veins that disrupt blood flow through tiny capillaries. High pressure then develops in veins, so they widen and rupture.

"You're actually born with them as opposed to aneurysms, which may, in part, have a congenital predisposition, but they're formed over time," said Allegheny General Hospital radiologist Dr. Robert Williams.

And because people are born with them, patients don't know they have them until the AVM bleeds or hemorrhages and causes a stroke.

There's different ways to treat AVMs, including radio surgery, open surgery or brain surgery, and there's something else called embolization or Onyx.

If surgeons can get a small catheter into the AVM, they can fill the abnormal vessels with Onyx.

Patients can be injected with Onyx one day and scheduled for follow-up surgery two days later, but that's not always necessary.

"We are more effectively able to reduce the size of the nidus, so the surgeons can remove the AVM or treat with gamma knife," said Williams.

Onyx has chemical properties that clog and shrink the tiny clusters enough to reduce blood loss before or after surgery. In fact, a recent study in the January issue of the American Journal of Neuro-Radiology shows Onyx reduced the size of AVMs an average of 75 percent and cured some all together, making surgery unnecessary.

Onyx is used for other conditions including trauma and certain cancers where bleeding needs to be controlled.

The American Stroke Association estimates 3 million Americans have AVMs and don't know it. For every year an AVM goes untreated, it brings a 4 percent risk of bleeding. So, a patient living 10 years with an AVM has a 40 percent chance it will rupture.

original...

Injecting Black "Goo" Into Brain May Nullify Surgery

Injecting Black "Goo" Into Brain May Nullify Surgery


In this age of high-tech medical breakthroughs, some brain surgeons say it's a simple black "goo" that's yielding some pretty remarkable results. It's called Onyx. Doctors are injecting it into their patients' brains to treat AVMs, or arterio-venous malformations. They are tangled coils of arteries and veins. In the past, the only way to treat them was by performing risky operations to cut them out. Now, doctors can inject Onyx into the AVM with eye-opening results.

Louis Caragine, M.D. at Ohio State University Medical Center says he often injects the black goo into his patients on Mondays, and schedules them for follow-up surgery two days later. Lately, that hasn't always been necessary.

"I'm sometimes able to cure the AVM or reduce its size so substantially, that I don't feel it's any longer justified for me to take them to surgery on Wednesday and open their head," says Caragine.

In fact, a recent study showed that the Onyx liquid reduced the size of AVMs an average of 75%, and cured some of them altogether, making surgery unnecessary.*

It's estimated about three million Americans have AVMs, although many don't even know it until they rupture or cause seizures.**

"Patients normally do not know they have it, until it bleeds and usually can hemorrhage and cause a stroke when a patient is in their 20's, 30's or 40's," says Caragine.

Next, doctors want to test Onyx to see if it can help patients survive strokes.

*Brain AVM Embolization with Onyx, American Journal of Neuroradiology , January 2007, vol 28, 172 - 177.

**What is an arteriovenous malformation? American Stroke Association, retrieved February 2008

Ohio State University Medical Center

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