Mahmoud Ehab, Koc Osman, Mahmoud Mostafa
Department of Neuroradiology, Neuroscience Institute, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar.
Neurointervention. 2025 Mar;20(1):28-31. doi: 10.5469/neuroint.2024.00521. Epub 2024 Dec 13.
There are few documented cases of bradycardia or asystole occurring during Onyx embolization of intracranial dural arteriovenous fistulas (DAVFs), although these events are more commonly observed in open neurosurgical procedures, particularly those involving the skull base. We present a case treated for a ruptured paramedian occipital DAVF. During the administration of Squid into the middle meningeal artery, while balloons were inflated in the large occipital arteries bilaterally to control the flow during embolization of the DAVF, the patient experienced an abrupt episode of sinus bradycardia, which recurred after a second injection of Squid. After temporarily halting the injections and deflating the balloons, a third injection was successfully administered without complications, allowing total exclusion of the fistula.
颅内硬脑膜动静脉瘘（DAVF）的Onyx栓塞过程中发生心动过缓或心搏停止的病例记录较少，尽管这些事件在开放性神经外科手术中更常见，尤其是那些涉及颅底的手术。我们报告一例治疗枕部旁正中破裂DAVF的病例。在将Squid注入脑膜中动脉时，双侧枕大动脉的球囊充气以控制DAVF栓塞过程中的血流，患者突然出现窦性心动过缓，在第二次注射Squid后再次出现。在暂时停止注射并放气球囊后，第三次注射成功进行且无并发症，实现了瘘口的完全闭塞。
