title: Onyx embolization of an extensive mandibular arteriovenous malformation via a dual lumen balloon catheter: a technical case report.
abstract: CONCLUSIONS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: St Luke's Roosevelt Hospital Center, Hyman Newman Institute of Neurology and Neurosurgery, New York 10019, USA. jfifi@chpnet.org
authors.forename: Johanna
authors.initials: J
authors.lastname: Fifi
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Niimi
authors.forename: Alejandro
authors.initials: A
authors.lastname: Berenstein
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000379:methods*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008334:Mandible / Q000098:blood supply / Q000000981:diagnostic imaging*; D011145:Polyvinyls / Q000008:administration & dosage*; D011859:Radiography
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide