title: Liquid embolization of brain arteriovenous malformation using novel detachable tip micro catheter: a technical report.
abstract: BACKGROUND
  Liquid embolization using Onyx® of brain arteriovenous malformations (AVMs) is sometimes limited by micro catheter retention by Onyx® cast during the disengagement process. Use of the new detachable tip micro catheter is presented in this report.
  
  
  METHODS
  Two feeding arteries of a previously ruptured brain AVM in a 62-year-old man were embolized by Onyx 18 prior to surgery using the new Apollo™ micro catheter with the detachable-tip (30 mm) was utilized. The arterial feeders were accessed without difficulty by micro catheter, guided by 0.010" microwire. Onyx reflux around the distal end of the micro catheter was necessary for effective embolization of arteriovenous fistulous components of brain AVM. The micro catheter was successfully retracted after embolization in both feeding arteries, with distal end detachment seen in one but not the other arterial embolization. No arterial thrombosis, vasospasm, dissection, or rupture was seen at respective sites of disengagement.
  
  
  CONCLUSIONS
  Use of the new micro catheters with detachable-tip design allowed prolonged Onyx® injection times, safe micro catheter disengagement, without any limitations in accessing target arterial feeders.
authors.affiliation: Zeenat Qureshi Stroke Institute and Department of Cerebrovascular Diseases and Interventional Neurology, Centracare Health, St Cloud MN 56303, USA.
authors.forename: Nabeel A
authors.initials: NA
authors.lastname: Herial
authors.affiliation: Zeenat Qureshi Stroke Institute and Department of Cerebrovascular Diseases and Interventional Neurology, Centracare Health, St Cloud MN 56303, USA.
authors.forename: Asif A
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Zeenat Qureshi Stroke Institute and Department of Cerebrovascular Diseases and Interventional Neurology, Centracare Health, St Cloud MN 56303, USA.
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.affiliation: Zeenat Qureshi Stroke Institute and Department of Cerebrovascular Diseases and Interventional Neurology, Centracare Health, St Cloud MN 56303, USA.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Sherr
authors.affiliation: Zeenat Qureshi Stroke Institute and Department of Cerebrovascular Diseases and Interventional Neurology, Centracare Health, St Cloud MN 56303, USA.
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
keywords: Arteriovenous malformation; Onyx; detachable-tip; embolization; liquid embolic agent; micro catheter