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  • Rupture of a detachable-tip microcatheter away from the detachment zone during Onyx 18 embolization of an arteriovenous malformation and management of the complication

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New devices and techniques
Case report
Rupture of a detachable-tip microcatheter away from the detachment zone during Onyx 18 embolization of an arteriovenous malformation and management of the complication
  1. Jonathan Cortese1,2,
  2. Oguzhan Coskun2,
  3. Federico Di Maria2,
  4. Silvia Pizzuto2,
  5. Georges Rodesch2,
  6. Arturo Consoli2
  1. 1 NEURI- Neurointerventional Radiology, Bicetre Hospital Interventional Neuroradiology, Le Kremlin-Bicetre, France
  2. 2 Department of Interventional and Diagnostic Neuroradiology, Hôpital Foch, Suresnes, Île-de-France, France
  1. Correspondence to Dr Arturo Consoli, Hôpital Foch, Suresnes, Île-de-France, France; a.consoli{at}hopital-foch.com

Abstract

Leakage of liquid embolic material is a rare but dreaded complication during embolization of an arteriovenous malformation (AVM). We describe the rupture of a microcatheter away from the detachment site and the successful removal of the cast of Onyx 18 in the carotid artery by aspiration. A young adult patient diagnosed with a right temporal unruptured AVM underwent endovascular embolization using Onyx 18. The AVM was approached using an Apollo microcatheter. After 4 min of Onyx 18 injection, leakage of Onyx 18 in the petrous segment of the internal carotid artery was noticed while the distal tip of the microcatheter remained patent. The plug of Onyx was successfully removed using an aspiration technique via the Envoy DA catheter. Analysis of the microcatheter confirmed that the rupture occurred away from the detachment site. However, no definite cause for the rupture has been identified.

  • arteriovenous malformation
  • complication
  • technique
  • intervention
  • device

http://dx.doi.org/10.1136/neurintsurg-2021-018349

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    Footnotes

    • Contributors JC and AC acquired the data and drafted the manuscript. All authors revised the paper critically for important intellectual content and provided final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.