Onyx embolization of an extensive mandibular arteriovenous malformation via a dual lumen balloon catheter: a technical case report
- St Luke's Roosevelt Hospital Center, Hyman Newman Institute of Neurology and Neurosurgery, New York, USA
- Correspondence to Dr J Fifi, St Luke's Roosevelt Hospital Center, Hyman Newman Institute of Neurology and Neurosurgery, 1000 Tenth Avenue, Suite 10G, NY 10019, USA;
Contributors JF, YN and AB contributed to the concept, authorship, revision and final review of the manuscript.
- Received 31 October 2011
- Revised 19 December 2011
- Accepted 27 December 2011
- Published Online First 16 January 2012
Summary The first known use of Onyx delivered via a dual lumen balloon catheter is reported. A mandibular arteriovenous malformation was successfully embolized with Onyx via an Ascent balloon catheter.
Case presentation A teenage girl presented with facial deformity and episodes of oral bleeding. Angiogram showed an extensive left mandibular arteriovenous malformation with ectatic intraosseous venous pouches. A dual lumen Ascent balloon catheter was placed in the inferior alveolar artery. With balloon inflation, Onyx was injected transarterially with excellent penetration into the venous puches. There was closure of over 80% of the lesion with reduction in arteriovenous shunting.
Conclusion Onyx embolization via a dual lumen balloon catheter allows for great penetration without the necessity of the long plug creation process for the usual ‘plug and push technique’ or the use of detachable tip microcatheters. The technique is limited by the deliverability of the balloon catheter, and is safest in the external carotid circulation.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.