Complete devascularization of a juvenile angiofibroma by direct percutaneous embolization with only ethylene vinyl alcohol copolymer (Onyx) through a single needle placement.

Abstract

Embolization of a juvenile angiofibroma (JNA) is commonly performed prior to surgical resection. Traditionally, it has been performed from an intra-arterial approach with particulate material. A novel technique is described in which a JNA was completely devascularized prior to surgical removal by direct percutaneous embolization with only ethylene vinyl alcohol. A midfacial degloving and medial maxillectomy/maxillotomy was then performed and the tumor extirpated with blunt finger dissection and the assistance of an endoscope, with 200 ml of blood loss.