PT - JOURNAL ARTICLE AU - Jonathan Cortese AU - Oguzhan Coskun AU - Federico Di Maria AU - Silvia Pizzuto AU - Georges Rodesch AU - Arturo Consoli TI - Rupture of a detachable-tip microcatheter away from the detachment zone during Onyx 18 embolization of an arteriovenous malformation and management of the complication AID - 10.1136/neurintsurg-2021-018349 DP - 2022 May 01 TA - Journal of NeuroInterventional Surgery PG - 508--510 VI - 14 IP - 5 4099 - http://jnis.bmj.com/content/14/5/508.short 4100 - http://jnis.bmj.com/content/14/5/508.full SO - J NeuroIntervent Surg2022 May 01; 14 AB - 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.