Management of brain AVM procedural hemorrhagic complication by the “security” catheter technique - 13/03/13
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Summary |
Since the introduction of Onyx as a liquid embolic agent for the treatment of brain arteriovenous malformation (AVM), higher endovascular cure rates have been achieved. This may be partially attributed to its non-adhesive property, which allows longer intranidal progression of the embolic agent before solidification. However, Onyx reflux around the microcatheter can form a highly viscous plug, thereby constraining the microcatheter during its retrieval. Also, during the maneuver, arterial stretching can lead to vascular rupture and result in acute bleeding, a potentially fatal complication that demands immediate treatment. This report describes a new treatment strategy for the rapid management of such a complication. The technique consists of the placement of a second microcatheter about 2cm proximal to the AVM nidus in the same artery containing the intranidal microcatheter. After conclusion of embolization, if rupture occurs during intranidal microcatheter retrieval, the second microcatheter that is already in place can promptly be used to control the bleeding.
Le texte complet de cet article est disponible en PDF.Keywords : Brain arteriovenous malformations, Endovascular treatment, Complications
Abbreviations : ACA, AVM, DSA, MCA, NBCA
Plan
Vol 40 - N° 1
P. 45-49 - mars 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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