J Korean Neurosurg Soc.  2012 Jun;51(6):374-376. 10.3340/jkns.2012.51.6.374.

Retained Microcatheter after Onyx Embolization of Intracranial Arteriovenous Malformation

Affiliations
  • 1Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 2Department of Diagnostic Radiology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Department of Neurosurgery, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea. chwachoi@pusan.ac.kr

Abstract

Endovascular embolization is being increasingly used to treat intracranial arteriovenous malformations (AVMs). However, we experienced two patients with retained microcatheters after AVM embolization using Onyx.

Keyword

Arteriovenous malformation; Onyx; Retained microcatheter

MeSH Terms

Arteriovenous Malformations
Humans
Intracranial Arteriovenous Malformations

Figure

  • Fig. 1 A : Non contrast enhanced brain computed tomography shows small amount of intraventricular hemorrhage in both lateral ventricle. B : Right vertebral artery angiography reveals small arteriovenous malformation (AVM) fed by right superior cerebellar artery braches and draining through internal cerebral vein (arrow). C : Superselective angiography demonstrates angioarchitecture of the AVM. D : Postprocedural radiography shows Onyx material. Black arrow indicates the cast of Onyx. E : Abdomino-pelvic computed tomography 2 years after embolization shows peripheral wall reposition of the retained microcatheter in descending aorta.

  • Fig. 2 Anterior-posterior view of plain X-ray of the skull and pelvis. Black arrows indicate a retained microcatheter in arteries.


Reference

1. Bingöl H, Sirin G, Akay HT, Ilyem H, Demirkilic U, Tatar H. Management of a retained catheter in an arteriovenous malformation. Case report. J Neurosurg. 2007; 106:481–483. PMID: 17367073.
2. Frizzel RT, Fisher WS 3rd. Cure, morbidity, and mortality associated with embolization of brain arteriovenous malformations : a review of 1246 patients in 32 series over a 35-year period. Neurosurgery. 1995; 37:1031–1039. discussion 1039-1040. PMID: 8584142.
3. Jafar JJ, Davis AJ, Berenstein A, Choi IS, Kupersmith MJ. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg. 1993; 78:60–69. PMID: 8416244.
Article
4. Jahan R, Murayama Y, Gobin YP, Duckwiler GR, Vinters HV, Viñuela F. Embolization of arteriovenous malformations with Onyx : clinicopathological experience in 23 patients. Neurosurgery. 2001; 48:984–995. discussion 995-997. PMID: 11334300.
Article
5. Jellinger K. Vascular malformations of the central nervous system : a morphological overview. Neurosurg Rev. 1986; 9:177–216. PMID: 3550522.
Article
6. Kelly ME, Turner R 4th, Gonugunta V, Rasmussen PA, Woo HH, Fiorella D. Monorail snare technique for the retrieval of an adherent microcatheter from an onyx cast : technical case report. Neurosurgery. 2008; 63:ONSE89. discussion ONSE89. PMID: 18728613.
7. Maimon S, Strauss I, Frolov V, Margalit N, Ram Z. Brain arteriovenous malformation treatment using a combination of Onyx and a new detachable tip microcatheter, SONIC : short-term results. AJNR Am J Neuroradiol. 2010; 31:947–954. PMID: 20190210.
Article
8. Natarajan SK, Ghodke B, Britz GW, Born DE, Sekhar LN. Multimodality treatment of brain arteriovenous malformations with microsurgery after embolization with onyx : single-center experience and technical nuances. Neurosurgery. 2008; 62:1213–1225. discussion 1225-1226. PMID: 18824988.
Article
9. Panagiotopoulos V, Gizewski E, Asgari S, Regel J, Forsting M, Wanke I. Embolization of intracranial arteriovenous malformations with ethylene-vinyl alcohol copolymer (Onyx). AJNR Am J Neuroradiol. 2009; 30:99–106. PMID: 18842759.
Article
10. Pérez-Higueras A, López RR, Tapia DQ. Endovascular treatment of cerebral AVM : our experience with Onyx. Interv Neuroradiol. 2005; 11:141–157.
Article
11. Pierot L, Januel AC, Herbreteau D, Barreau X, Drouineau J, Berge J, et al. Endovascular treatment of brain arteriovenous malformations using onyx : preliminary results of a prospective multicenter study. Interv Neuroradiol. 2005; 11:159–164. PMID: 20584470.
Article
12. Santillan A, Zink W, Knopman J, Riina H, Gobin YP. Balloon-assisted technique for trapped microcatheter retrieval following onyx embolization. A case report. Interv Neuroradiol. 2009; 15:453–455. PMID: 20465885.
Article
13. Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986; 65:476–483. PMID: 3760956.
Article
14. Stapf C, Mast H, Sciacca RR, Berenstein A, Nelson PK, Gobin YP, et al. The New York Islands AVM Study : design, study progress, and initial results. Stroke. 2003; 34:e29–e33. PMID: 12690217.
15. van Rooij WJ, Sluzewski M, Beute GN. Brain AVM embolization with Onyx. AJNR Am J Neuroradiol. 2007; 28:172–177. discussion 178. PMID: 17213451.
16. Velat GJ, Reavey-Cantwell JF, Sistrom C, Smullen D, Fautheree GL, Whiting J, et al. Comparison of N-butyl cyanoacrylate and onyx for the embolization of intracranial arteriovenous malformations : analysis of fluoroscopy and procedure times. Neurosurgery. 2008; 63:ONS73–ONS78. discussion ONS78-ONS80. PMID: 18728607.
17. Weber W, Kis B, Siekmann R, Kuehne D. Endovascular treatment of intracranial arteriovenous malformations with onyx : technical aspects. AJNR Am J Neuroradiol. 2007; 28:371–377. PMID: 17297015.
18. Zoarski GH, Lilly MP, Sperling JS, Mathis JM. Surgically confirmed incorporation of a chronically retained neurointerventional microcatheter in the carotid artery. AJNR Am J Neuroradiol. 1999; 20:177–178. PMID: 9974078.
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