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Rescue N-butyl-2 cyanoacrylate embolectomy using a Solitaire FR device after venous glue migration during arteriovenous malformation embolization: technical note
- Source :
- Journal of Neurosurgery. 125:173-176
- Publication Year :
- 2016
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2016.
-
Abstract
- One of the procedural risks in arteriovenous malformation (AVM) embolization is possible migration of the embolic agent into the venous drainage with an incomplete nidus occlusion, which may lead to severe hemorrhagic complications. This report presents the case of a 29-year-old man who presented with a deep intraparenchymal hematoma on the left side secondary to the spontaneous rupture of a claustral AVM. Upon resorption of the hematoma, the patient underwent an initial therapeutic session of N-butyl-2 cyanoacrylate endovascular embolization, with the purpose of reducing the AVM volume and flow before performing Gamma Knife radiosurgery. After glue injection into one of the arterial feeders, the control angiography showed a partial migration of the glue cast into the straight sinus, with most of the nidus still visible. Because of the bleeding risk due to possible venous hypertension, it was decided to try to retrieve the glue from the vein by using a stent retriever via jugular access. This maneuver allowed a nearly complete removal of the glue cast, thereby restoring normal venous flow drainage. The patient showed no clinical worsening after the procedure. To the authors’ knowledge, this is the first report of the use of the Solitaire FR device as a rescue glue retriever. This method should be considered by physicians in cases of unintended glue migration into the venous circulation during AVM embolization.
- Subjects :
- Adult
Intracranial Arteriovenous Malformations
Male
medicine.medical_specialty
Solitaire Cryptographic Algorithm
medicine.medical_treatment
Embolectomy
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Hematoma
Foreign-Body Migration
medicine
Humans
Embolization
Vein
medicine.diagnostic_test
business.industry
Arteriovenous malformation
General Medicine
Enbucrilate
medicine.disease
Embolization, Therapeutic
Surgery
surgical procedures, operative
medicine.anatomical_structure
Intracranial Embolism
Angiography
Radiology
business
030217 neurology & neurosurgery
Straight sinus
Subjects
Details
- ISSN :
- 19330693 and 00223085
- Volume :
- 125
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery
- Accession number :
- edsair.doi.dedup.....13f39145f03a4828bed36da9470b3dee
- Full Text :
- https://doi.org/10.3171/2015.5.jns15145