Successful use of Onyx® for transcatheter arterial embolization of a scrotal arteriovenous malformation refractory to traditional embolic agents

A scrotal arteriovenous malformation (AVM) is a rare condition representing an abnormal connection between the arterial and venous systems of vessels supplying the scrotum. Scrotal AVMs are usually treated via transcatheter embolization, surgical extirpation, or a combination of the two approaches. A 41-year-old man developed a life-threatening hemorrhage from a scrotal AVM. After hemodynamic stability was attained, multiple transcatheter embolization procedures were performed (over the course of several months) to eliminate blood flow through the AVM. Traditional embolic agents including microcoils, Embospheres®, and Gelfoam® were used, with only temporary reduction of blood flow through the AVM. Onyx®, a liquid embolic agent, was used successfully as an adjunct treatment to achieve blood flow cessation. Onyx® demonstrates efficacy in the treatment of scrotal AVMs, and is a viable alternative to traditional embolic agents.