{
  "abstract": "Glued microcatheter is a rare complication during embolization of arteriovenous malformations (AVMs). Following the availability and popularization of Onyx, the incidence of retained catheter has become lesser. Though there have been reports of retained microcatheter during embolization of AVM with Onyx. We report a case of endovascular removal of a freely floating of glued microcatheter during embolization of an arteriovenous malformation with Onyx. A 56-year-old man suffers from a posterior occipital arteriovenous fistula with subarachnoid drainage supplied by several feeders (upside pharyngeal aa, right posterior inferior cerebellum aa, left posterior meninges aa, left posterior occipital aa, right relative cerebellum aa) In the first embolization session, we attempt embolization through the posterior meningeal artery pathway using Onyx 18 HD. However, we cannot completely embolize. Final control angiography shows the remaining right ascending pharyngeal artery and right posterior descending cerebellar artery feeder. And we attempt embolization through the newly recognized right ascending cerebellar artery pathway. After unsuccessful Onyx embolization, we attempt to remove the Apollo microcatheter. However, we cannot remove the microcatheter after a few attempts. So, we decide to maintain the microcatheter at the femoral artery perforation site. In the process of maintaining the microcatheter, the proximal part of the microcatheter was moved to the aortic arch. That’s when a portion of the microcatheter enters the left ventricle of the heart. Arrhythmia has developed. We try to remove the microcatheter that freely floats in a 4 cm diameter snare, and finally recover the microcatheter successfully. Therefore, we report a rare case of successful removal of a free-floating maintenance microcatheter using a large snare during Onyx embolization for posterior tibial sinus with subarachnoid drainage.Disclosures S. Sheen: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, CHA University, Bundang CHA Medical Center, Sung nam, Korea, Republic of"
      ],
      "name": "S Sheen"
    }
  ],
  "title": "E-355 Endovascular removal of freely floating retained microcatheter at aortic arch with snare",
  "uid": "60ee37b2-3e77-5509-891c-5fdf643bdade"
}