Retrieving microcatheters from Onyx casts in a series of brain arteriovenous malformations: a technical report

Alamri, Alexander; Hyodo, Akio; Suzuki, Kensuke; Tanaka, Yoshihiro; Uchida, Takanori; Takano, Issei; Kowata, Kazuma; Iwatate, Kensho; Suzuki, Rikako

doi:10.1007/s00234-011-0971-y

Cited by 13 publications

(11 citation statements)

References 6 publications

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“…1, thrombectomy was performed subsequently. Given the probable endothelial damage, subsequent use of antiplatelets has been recommended [5], as this was done in the two presented patients. Mechanical vasospasm is a potential risk of retrieval maneuvers [5], but this did not occur in our reported cases.…”

Section: Discussionmentioning

confidence: 99%

“…Snare devices have been previously used to retrieve stretched platinum coils [11] or detached stents [7]. Microsnares have also been used to retrieve Onyx-entombed catheters [5]. Microsnares are favorable for foreign body retrievable due to flexible loops which allow entrapment of objects with different geometries and withdrawal into carrying sheath.…”

Section: Discussionmentioning

confidence: 99%

“…Given the probable endothelial damage, subsequent use of antiplatelets has been recommended [5], as this was done in the two presented patients. Mechanical vasospasm is a potential risk of retrieval maneuvers [5], but this did not occur in our reported cases. Catheter retrieval was successful in two different vascular anatomic locations, i.e., the anterior and posterior circulations, suggesting that this technique can be broadly used.…”

Section: Discussionmentioning

confidence: 99%

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Direct Aspiration Catheter Fracture and Retrieval during Neurothrombectomy

Moshayedi¹,

Jadhav²

2018

Intervent Neurol

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Background: Application of direct aspiration catheters has revolutionized acute stroke care and has led to significant improvement in clinical outcome with a good safety profile. Catheter fracture and retention is a rare but potentially devastating complication. Case Description: Here we present two cases of acute stroke complicated by aspiration catheter fracture and retention. Successful catheter retrieval and revascularization was achieved in both cases. The stenosis or tortuosity of vascular anatomy appears to be the probable contributor to catheter breakage by anchoring the catheter with resultant fracture at the constraint point from catheter withdrawal tensile stress. Conclusion: This report describes application of snare devices in retrieving a broken catheter during thrombectomy in the anterior and posterior circulation, and therefore presents a technique that can be safely utilized to address catheter breakage complicating thrombectomy in different vascular anatomic locations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Direct Aspiration Catheter Fracture and Retrieval during Neurothrombectomy

Moshayedi¹,

Jadhav²

2018

Intervent Neurol

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“…If a tip fractures or the embolic migrates, both securing the fragment to the vessel wall with a stent 48 and endovascular retrieval of the fragment have been successful. 52 The middle meningeal artery may provide a safer route for Onyx embolization as a result of both ease of access and the ability of the artery to resist tension during withdrawal of the microcatheter because the artery is anchored in bone and dura.…”

Section: Onyxmentioning

confidence: 99%

Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas

et al. 2014

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Endovascular treatment options for dural arteriovenous fistulas (DAVFs) have vastly expanded and become progressively safer in the last several years. Angiographic imaging systems have improved, catheter technology has advanced, and liquid embolic and coil options have increased. As a likely result, an increasing proportion of DAVFs are treated via an endovascular approach. In addition to allowing physicians to appreciate and treat lesions better, varied approaches have been developed. The "plug and push" technique and the new availability of dimethyl sulfoxide--compatible dual lumen balloons have allowed safer and more thorough transarterial treatments. Transvenous treatment has proved to be a valuable technique for some lesions. Hybrid approaches with surgical assisted access to vascular structures have been successfully used to treat more challenging fistulas.

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“…Endovascular options that could be performed during the same procedure are monorail snare technique [4,7], over the catheter retrieval [4] or balloon-assisted retrieval [8]. An entrapped microcatheter can be surgically retrieved during subsequent microsurgical resection [2].…”

Section: Discussionmentioning

confidence: 99%

Mechanical Removal of Migrated Onyx Due to Microcatheter Rupture During AVM Embolization: A Technical Case Report

Senturk

2015

Cardiovasc Intervent Radiol

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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.

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Retrieving microcatheters from Onyx casts in a series of brain arteriovenous malformations: a technical report

Abstract: The monorail snare technique is a safe and easy technique for retrieving Onyx-encased microcatheter tips in the treatment of BAVM.

Cited by 13 publications

References 6 publications

Direct Aspiration Catheter Fracture and Retrieval during Neurothrombectomy

Direct Aspiration Catheter Fracture and Retrieval during Neurothrombectomy

Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas

Mechanical Removal of Migrated Onyx Due to Microcatheter Rupture During AVM Embolization: A Technical Case Report

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