title: Mechanical Removal of Migrated Onyx Due to Microcatheter Rupture During AVM Embolization: A Technical Case Report.
abstract: We report a case where migrated Onyx could be removed safely with a mechanical thrombectomy device after withdrawal of the damaged microcatheter. A microcatheter was retained in the superior cerebellar artery with attached Onyx fragments on its tip during embolization of a bled cerebellar AVM. During retrieval maneuvers microcatheter shaft was ruptured and Onyx fragments were released into the vertebrobasilar system causing occlusion. Finally, Onyx fragment on tip of the microcatheter could be detached with dimethyl sulfoxide injection and the microcatheter could be withdrawn. A Merci retriever device (Concentric Medical, Mountain View, CA, USA) was successfully used to retrieve most of the dislodged Onyx material and recanalize the vertebrobasilar circulation.
authors.affiliation: Division of Neurointerventional Radiology, Department of Radiological Sciences, University of California, Irvine Medical Center, 101 The City Drive South Route 140, Orange, CA, 92868, USA. caginsenturk@yahoo.com.
authors.forename: Cagin
authors.initials: C
authors.lastname: Senturk
mesh_terms: D000368:Aged; D057785:Catheters; D004121:Dimethyl Sulfoxide; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000628:therapy*; D008297:Male; D011145:Polyvinyls; D011859:Radiography; D017131:Thrombectomy
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Mechanical; Microcatheter; Migration; Onyx; Removal; Rupture