Abstract: Objective To evaluate the feasibility, efficacy and safety of a new method for distant injection of Onyx for treatment
of intracranial arteriovenous malformations (AVMs). Methods The clinical data of 26 patients with AVMs receiving distant
injection of Onyx using the new method were retrospectively analyzed. Onyx was injected by the surgeon in the control room
through a pressure transmission system. Results The 26 patients received a total of 31 embolization procedures, with an
average estimated size reduction of AVMs of (61.48±26.85)%. Total obliteration was achieved in 3 AVMs. In one case, Onyx
leakage occurred during the operation resulting from a broken microcatheter, and the patient developed hemiparesis after the
operation. Conclusion Endovascular treatment of intracranial AVMs with Onyx embolization using this new distant injection
method is feasible, safe and effective. This method minimizes potential radiation exposure of the surgeons without increasing
the risks of related complications.