Korean J Radiol.  2000 Dec;1(4):208-211. 10.3348/kjr.2000.1.4.208.

Successful Management with Glue Injection of Arterial Rupture Seen during Embolization of an Arteriovenous Malformation Using a Flow-Directed Catheter: A Case Report

• Hong JW
• Baik SK
• Shin MJ
• Choi HY
• Kim BG

• KMID: 1378946
• DOI: http://doi.org/10.3348/kjr.2000.1.4.208

Abstract

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed micro-catheter,was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superse-lective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recogni-tion and closure of the perforation site is essential for good prognosis.

Keyword

Arteriovenous malformations; Interventional neuroradiology; Interventional procedures, complications

MeSH Terms

Adult
Case Report
Cerebral Arteries/*injuries
Embolization, Therapeutic/*adverse effects
*Enbucrilate
Human
Intracranial Arteriovenous Malformations/*therapy
*Iodized Oil
Male
Rupture

Figure

• 

  Fig. 1 A. Axial enhanced CT reveals a left occipital arteriovenous malformation (open arrows). A hematoma (arrows) is seen in the left parietal lobe. No feeding artery appears in this section. B. Lateral angiograms of the left internal carotid artery disclose an occipital arteriovenous malformation fed by the left posterior parietal artery and branches of the posterior cerebral artery. C. Anteroposterior test injection shows contrast extravasation into the subarachnoid space at the point at which the parieto-occipital branch changes direction, the site of the microcatheter tip, approximately 1.5 cm from the nidus. D. Plain lateral view shows a mixture of histoacryl and lipiodol after occlusion of the arterial rupture with glue (arrow), and change in the position and shape of the initial extravasation of contrast medium is seen. Note the presence of glue cast arising from initial embolization of the left posterior parietal artery (open arrows). E. Plain lateral view obtained 139 minutes after initial contrast extravasation shows no evidence of further extravasation.

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