Singla Amit, Fargen Kyle Michael, Hoh Brian
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA University of Florida, Gainesville, Florida, USA.
J Neurointerv Surg. 2016 Sep;8(9):e38. doi: 10.1136/neurintsurg-2015-011879.rep. Epub 2015 Jul 31.
A man in his sixties referred with symptoms of episodic left lip numbness and left arm weakness was diagnosed with a Borden type 3 dural arteriovenous fistula (DAVF) on DSA. Successful Onyx embolization of the DAVF was performed via the distal left occipital artery using an ev3 Apollo detachable tip microcatheter. He underwent surgical obliteration for the residual DAVF 3 days later. Three months later during a routine postoperative clinic visit, the patient produced a plastic bag containing multiple small pieces of Onyx cast and the detached tip of the Apollo microcatheter that had extruded out from his scalp through small spontaneous holes about 5 weeks after the embolization procedure. This spontaneous extrusion of Onyx can be alarming to the patient not expecting it; however, prior knowledge and discussion can lessen the anxiety of both the treating physician and the patient dealing with such a situation.
一名60多岁男性，因发作性左侧唇部麻木和左臂无力症状前来就诊，经数字减影血管造影（DSA）诊断为博登3型硬脑膜动静脉瘘（DAVF）。使用ev3 Apollo可脱性头端微导管经左侧枕叶远端动脉对DAVF成功进行了Onyx栓塞。3天后，他接受了残余DAVF的手术闭塞。术后3个月常规门诊随访时，患者拿出一个塑料袋，里面装着多个小块Onyx铸型以及栓塞术后约5周从头皮上小的自发孔中挤出的Apollo微导管的可脱头端。Onyx的这种自发挤出可能会让毫无心理准备的患者感到惊慌；然而，提前了解并进行讨论可以减轻治疗医生和应对这种情况的患者的焦虑。
