Cerebral arteriovenous malformation (AVM) is a congenital vascular malformation formed by abnormal development of cerebral blood vessels during embryonic period, and aneurysm is an abnormal bulge in the wall of artery, both are the most common clinical hemorrhagic cerebrovascular disease, prone to epileptic convulsions, neurological dysfunction and rupture bleeding. The treatment of AVM and aneurysm has been a major problem in neurosurgery for many years. The treatment of cerebral AVM includes AVM focal resection, endovascular embolization and stereotactic radiation therapy. Among them, AVM focal resection and stereotactic radiotherapy are only effective for some patients due to the limitation of indications. In the past decade, with the development of endovascular interventional technology, endovascular embolization has become more and more widely used and has become a very important part of the comprehensive treatment plan for cerebral AVM. While the traditional treatment for intracranial aneurysms is aneurysm neck clamping, endovascular embolization is an emerging minimally invasive and highly effective treatment method. The more common embolization material for cerebral AVM is NBCA, but it has the shortcomings of sticky tube and low rate of complete embolization; the more common embolization material for aneurysm is GDC, although GDC treatment of aneurysm has been a landmark revolution in endovascular neurosurgery, but GDC embolization of aneurysm still has the limitation that the matching is not yet ideal. Advances in interventional materials research, a new embolic agent-ONYX liquid embolic agent has broken into brain surgery, allowing patients to see a new light. ONYX is a new type of intravascular non-adhesive liquid embolic agent composed of hypovinyl alcohol heteropolymer (EVOH), DMSO (dimethyl sulfoxide) and tantalum powder particles in a certain ratio of suspension. The biggest difference between ONYX and the commonly used NBCA is that ONYX is a non-adhesive embolic agent, which can avoid the adhesion of microcatheter and blood vessel, making it easier and safer to withdraw the microcatheter after the embolization of the lesion, not only the doctor does not need to end the “battle” in a hurry, but more importantly is the back of the embolic agent can push the front continue to move forward and dispersion, to reach more small, catheter can not reach the branch vessels, so as to achieve the possibility of complete embolization of the lesion, histopathological assessment shows ONYX to the lesion penetration, can permanently embolize 80µm microvessels, injected into the lesion into the spongy expansion and occlusion of the lesion; second, ONYX will not quickly Second, ONYX does not rapidly coagulate and block the catheter, so the physician can move the microcatheter to another malformed vessel in the lesion area before it coagulates and continue embolization therapy. In contrast, NBCA is an adhesive embolic agent, which will rapidly coagulate after injection and cause rapid adhesion of the catheter to the vessel, so it is not allowed to return, otherwise the microcatheter may be stuck in the lesion by the embolic agent and cannot be pulled out; and a microcatheter can only be injected with NBCA once. According to statistics, the use of ONYX treatment of cerebral arteriovenous malformation of a complete embolization rate can be as high as 44%, the complete embolization rate of sub-treatment will be higher, while NBCA is much lower, the literature reports that the highest can only reach 10-13%. Therefore, the world’s neurointerventional authority, Professor Moret of France, believes that the emergence of ONYX has become a milestone breakthrough in the treatment of cerebral arteriovenous malformations. Our department in the ONYX embolization AVM animal model after the success, since 2003 began to carry out the ONYX embolization brain AVM clinical experimental research, clinical experiments concluded: ONYX embolization arteriovenous malformation can be injected for a long time without sticky tube, easy to control, good visibility, low complications, embolization effect is reliable, is the ideal embolic agent. We appreciate that when using ONYX for patient treatment, it is best to keep patients under anesthesia for 24 hours postoperatively if the lesion is completely followed by near-total embolization, and to strictly control the patient’s blood pressure. Because when the lesion exists, it can shunt the blood, so that the blood vessels around the lesion are in a long-term low perfusion dilated state and lose the role of regulating blood flow, when the lesion is embolized, the normal blood flow in the vessels around the lesion will suddenly increase, the pressure of the vessel wall increases, and these vessels still lack the contraction regulation feedback mechanism, which can easily cause the normal vessels around the lesion to suddenly rupture and bleed after surgery, which is called “normal perfusion pressure breakthrough”, which can cause the treatment to be abandoned and the condition to deteriorate or even cause the patient’s death. In fact, as a non-adhesive liquid embolization material ONYX applied to the embolization of aneurysms performed equally well, ONYX and balloon or intravascular metal stents combined to treat aneurysms, animal test embolization results are encouraging, in the clinical treatment of patients with aneurysms also achieved good embolization treatment effect, a complete embolization of the aneurysm cure rate can be as high as 90%, foreign scholars’ research results and our animal and clinical results also support this view. For large or huge aneurysms ONYX embolization has some advantages over platinum coil GDC for aneurysm treatment, because ONYX is a liquid embolization material and matches better with the aneurysm lumen than other solid embolization materials, so complete embolization and aneurysm neck reconstruction may be more desirable and the postoperative aneurysm recanalization rate may be lower. Although GDC and GDC-assisted stent and balloon techniques for the treatment of aneurysms have been a landmark revolution in endovascular neurosurgery and are now the mainstream method for embolization of aneurysms, the advent of ONYX has undoubtedly added another effective tool for aneurysm patients. Of course, in our ONYX clinical practice also found ONYX has some shortcomings: first of all, the price is more expensive, ONYX in the global sales price is not uniform, because in China in the promotion stage, the dosage is relatively small, so the price is more than twice as expensive than the United States mainland. Secondly, the solvent DMSO in ONYX has certain potential vascular toxicity, although usually when injected slowly, patients can tolerate, our animal tests also precisely this, but this is after all the potential shortcomings of this embolic agent, in the intravascular embolization treatment of arteriovenous malformations, aneurysms and other diseases to strictly control the amount of DMSO and injection time, the operation should be slowly injected to achieve effective occlusion The operation should be slow to achieve effective occlusion of the lesion; ONYX liquid embolic agent has a certain corrosive, can make ordinary catheter deformation or damage, so it requires the use of special matching microcatheter. Third, the use of ONYX for the operating physician’s requirements are also high, must allow the microcatheter to reach the malformation of the vascular mass before being able to inject ONYX, otherwise will embolize the normal vessels may lead to serious complications; ONYX use of a high threshold of access, whether it is China or Europe and the United States doctors, must be approved by the production company’s training before being able to clinical use ONYX. We believe that, with the We believe that with further improvement of the microcatheter and delivery system, clinical endovascular physicians’ skill in operation, and further research on cerebral arteriovenous malformations and aneurysms, ONYX liquid embolization agent will further improve the embolization treatment effect of cerebral AVMs and is expected to further expand its application in the treatment of aneurysms, thus providing an opportunity for more patients suffering from painful and life-threatening cerebral arteriovenous malformations and aneurysm patients suffering from painful and life-threatening disease.