Menox™ Liquid Embolic System

Key feature: in situ cohesive occlusion technology

The Menox™ system is based on the biocompatible EVOH copolymer. Upon contact with blood or interstitial fluids, the material forms an outer polymer shell, after which the solidification process continues from the outside inward.

As a result, a cohesive embolus is formed, intended for controlled occlusion of the pathological vascular bed.

Clinical features and mechanism of action

• Non-adhesive properties: unlike adhesive embolic materials, Menox™ is not intended to adhere to vessel walls or instruments. This allows slow and controlled injection of the material.
• Microcatheter control: the absence of pronounced adhesion helps reduce the risk of delivery microcatheter entrapment and facilitates its removal after embolization.
• Viscosity range: the system is available in different viscosity options. Lower-viscosity variants may be used for penetration into feeding vessels near the malformation nidus, while higher-viscosity formulations may be used for embolization of high-flow fistulas and larger-diameter vessels.

Visualization and procedural control

• Radiopacity: micronized tantalum powder in the material provides visualization of the embolic agent under fluoroscopic guidance.
• Step-by-step injection control: the physician can monitor the stages of microcatheter filling and embolic material distribution within the target area.
• Post-injection angiographic assessment: if necessary, angiographic control may be performed after material injection to assess the degree of occlusion and decide on additional embolization steps.

Safety and procedure workflow

• Microcatheter preparation: dimethyl sulfoxide (DMSO) is used to prepare and flush the system, filling the microcatheter dead space and reducing the risk of premature material precipitation.
• Color-coded syringes: specialized syringes with color-coded plungers help visually distinguish the embolic material from the flushing agent during the procedure.
• Permanent embolic material: after solidification, Menox™ forms a stable embolus within the target vascular bed. Long-term occlusion stability and recanalization risk should be stated only based on manufacturer data or clinical studies.

Indications and areas of use

• Preoperative embolization of cerebral arteriovenous malformations (AVMs).
• Controlled occlusion of neurovascular pathologies using compatible microcatheters — if specified in the manufacturer’s instructions.

Materials used

• EVOH, ethylene-vinyl alcohol copolymer: a biocompatible polymer that forms an embolic cast of the vascular bed.
• DMSO, dimethyl sulfoxide: a solvent and system preparation agent used before injection of the embolic material.
• Micronized tantalum: a radiopaque component that enables visualization of the material under fluoroscopy.

System components

The system is supplied as a set for embolization procedures, with the final configuration corresponding to the manufacturer’s supplied kit:

• vial with liquid embolic material of the selected viscosity;
• vial with DMSO for system preparation and flushing;
• set of specialized DMSO-compatible syringes with color-coded plungers.

Certification and safety

• System components are supplied sterile, if confirmed by the manufacturer’s documentation.
• The system is intended for single use.
• Non-pyrogenic status, sterilization method, and CE marking should be stated in accordance with current manufacturer documentation.