RT Journal Article
SR Electronic
T1 Rupture of a detachable-tip microcatheter away from the detachment zone during Onyx 18 embolization of an arteriovenous malformation and management of the complication
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 508
OP 510
DO 10.1136/neurintsurg-2021-018349
VO 14
IS 5
A1 Jonathan Cortese
A1 Oguzhan Coskun
A1 Federico Di Maria
A1 Silvia Pizzuto
A1 Georges Rodesch
A1 Arturo Consoli
YR 2022
UL http://jnis.bmj.com/content/14/5/508.abstract
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.