Retrieval of a migrated <i>N</i>-butyl-2 cyanoacrylate cast using a snare-kit system during dural AVF embolization: A case report

Ahmed, Ramy; Ide, Satomi; Kiyosue, Hiro; Tanoue, Shuichi; Matsumoto, Shunro; Mori, Hiromu

doi:10.1177/1591019918775957

Cited by 1 publication

(1 citation statement)

References 9 publications

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“…There were two retrieval cases of migrated NBCA glue during TAE for intracranial arteriovenous malformation and DAVF due to venous outflow obstruction using the Solitaire FR or Snare-kit system. 18 , 19) Chauhan et al reported a retrieval case of NBCA glue that migrated into the middle cerebral artery 7 hours after TAE for orbital meningioma. 20) They retrieved the NBCA glue using the Solitaire and Penumbra devices.…”

Section: Discussionmentioning

confidence: 99%

Retrieval of N-Butyl-2-Cyanoacrylate Glue Migrated to the Vertebral Artery via Dangerous Anastomosis, Using the Stent-Retriever Aspiration Technique, during Dural Arteriovenous Fistula Embolization: A Case Report

Kiyomoto

Sato

Yanagawa

et al. 2023

JNET

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Objective: We report a case of accidental N-butyl-2-cyanoacrylate (NBCA) glue migration into the vertebral artery (VA) via dangerous anastomosis during transarterial embolization (TAE) for transverse sinus (TS)-dural arteriovenous fistula (DAVF), which was rescued by mechanical retrieval using a stent retriever and aspiration devices.Case Presentation: A 49-year-old right-handed female patient was admitted to our hospital with motor aphasia. MRI revealed congestion in the left temporal and occipital lobes, involving a small hemorrhage. DSA revealed a DAVF complicated by a sinus thrombus in the left TS. The DAVF was mostly fed by the left occipital artery (OA) and drained into the cortical veins of the temporal and occipital lobes through the patent part of the sinus. TAE was performed via the left OA with low-concentration NBCA. However, NBCA glue migrated into the left VA through a dangerous anastomosis, and a left VA angiogram revealed severe VA stenosis and floating NBCA glue. There was a fragile attachment of the NBCA glue to the arterial inner wall; therefore, we successfully retrieved the NBCA glue with a stent retriever and aspiration devices without complications. Finally, TAE was performed using another feeder, and the DAVF was completely obliterated. Conclusion: TAE using NBCA is useful for the treatment of DAVF; however, it should be noted that there is a risk of migration via potential anastomotic routes. Low-concentration NBCA glue can be retrieved using these devices in limited cases.

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Section: Discussionmentioning

confidence: 99%