{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:22:16Z","timestamp":1759191736217,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2013,11,29]]},"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Onyx HD-500 embolization of intracranial aneurysms leads to high rates of complete and durable occlusion. However, little information exists as to what constitutes an optimal immediate angiographic result. We devised a simple grading scheme based on the pattern of parent artery and aneurysm neck reconstruction, and correlated it with long term outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All cases of Onyx embolization for unruptured aneurysms performed between September 2008 and April 2010 were retrospectively reviewed. Immediate angiographic results were categorized according to the pattern of extra-aneurysmal Onyx leakage: grade A, none; grade B, \u2018hat brim\u2019 lamination; and grade C, \u2018ectopic\u2019 Onyx (C1, non-flow limiting; C2, flow limiting). Results of follow-up vascular imaging were reviewed and correlated with the angiographic grade.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>24 embolization procedures were performed in 21 patients with 23 aneurysms. Aneurysm size ranged from 2.5 to 24\u2005mm and neck width from 2 to 8\u2005mm. Complete occlusion was achieved in 20 cases (83.3%) and subtotal occlusion in three (12.5%). Immediate angiographic results were: grade A in ten (41.7%), grade B in eight (33.3%), and grade C in six (25%). Stable angiographic results were seen in 85%, 94%, 94%, and 100% at 6, 12, 24, and 36\u2005months, respectively. Angiographic recurrence was observed in four cases (16.7%), all grade A (p=0.006). Delayed parent vessel occlusion occurred in two cases (8.3%), both grade C2 (p=0.014).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This simple grading system may help predict long term angiographic results. Hat brim Onyx lamination seems to provide an optimal balance between treatment durability and parent vessel patency. Prospective validation is warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2013-010943","type":"journal-article","created":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T00:39:15Z","timestamp":1393547955000},"page":"754-760","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Predicting parent vessel patency and treatment durability: a proposed grading scheme for the immediate angiographic results following Onyx HD-500 embolization of intracranial aneurysms"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1796-7296","authenticated-orcid":false,"given":"Ralph","family":"Rahme","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, Ohio, USA"},{"name":"Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Grande","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, Ohio, USA"},{"name":"Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lincoln","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A","family":"Abruzzo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, Ohio, USA"},{"name":"Mayfield Clinic, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Ringer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine and Comprehensive Stroke Center at UC Neuroscience Institute, Cincinnati, Ohio, USA"},{"name":"Mayfield Clinic, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,2,27]]},"reference":[{"key":"2025092912112918000_6.10.754.1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.3171\/jns.2002.96.3.0474","article-title":"Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection","volume":"96","author":"Mawad","year":"2002","journal-title":"J Neurosurg"},{"key":"2025092912112918000_6.10.754.2","first-page":"39","article-title":"Cerebral Aneurysm Multicenter European Onyx (CAMEO) trial: results of a prospective observational study in 20 European centers","volume":"25","author":"Molyneux","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092912112918000_6.10.754.3","first-page":"1909","article-title":"Treatment and follow-up of 22 unruptured wide-necked intracranial aneurysms of the internal carotid artery with Onyx HD 500","volume":"26","author":"Weber","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092912112918000_6.10.754.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-005-0007-6"},{"key":"2025092912112918000_6.10.754.5","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000340977.68347.51"},{"key":"2025092912112918000_6.10.754.6","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1227\/01.NEU.0000374772.22745.C3","article-title":"Endovascular treatment of side wall aneurysms using a liquid embolic agent: a US single-center prospective trial","volume":"67","author":"Simon","year":"2010","journal-title":"Neurosurgery"},{"key":"2025092912112918000_6.10.754.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2011.02.003"},{"key":"2025092912112918000_6.10.754.8","doi-asserted-by":"publisher","DOI":"10.1161\/hs0901.095600"},{"key":"2025092912112918000_6.10.754.9","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2003.98.5.0959"},{"key":"2025092912112918000_6.10.754.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000073841.88563.E9"},{"key":"2025092912112918000_6.10.754.11","first-page":"762","article-title":"Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms","volume":"23","author":"Tamatani","year":"2002","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092912112918000_6.10.754.12","first-page":"1726","article-title":"Endovascular treatment of experimental aneurysms by use of a combination of liquid embolic agents and protective devices","volume":"21","author":"Murayama","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092912112918000_6.10.754.13","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/109\/7\/0077"},{"key":"2025092912112918000_6.10.754.14","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1227\/NEU.0b013e3182350da5","article-title":"Management of residual and recurrent aneurysms after initial endovascular treatment","volume":"70","author":"Dorfer","year":"2012","journal-title":"Neurosurgery"},{"key":"2025092912112918000_6.10.754.15","first-page":"770","article-title":"Microsurgical removal of Onyx HD-500 from an aneurysm for relief of brainstem compression","volume":"113","author":"Van Loock","year":"2010","journal-title":"Case report. J Neurosurg"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2013-010943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T19:11:40Z","timestamp":1759173100000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2013-010943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,27]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2014,11,7]]},"published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1136\/neurintsurg-2013-010943"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2013-010943","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"type":"print","value":"1759-8478"},{"type":"electronic","value":"1759-8486"}],"subject":[],"published":{"date-parts":[[2014,2,27]]}}}