{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:57Z","timestamp":1756339377094,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,15]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Endovascular embolisation of arteriovenous malformations (AVM) has been greatly facilitated by liquid embolic agents. While advancements in catheter technology and techniques of creating a proximal plug minimise the risk of inadvertent proximal reflux of the embolysate, this remains one of the main complications associated with use of liquid embolics.<\/jats:p>\n               <jats:p>We report a case of paediatric AVM embolisation which was complicated by parent vessel occlusion due to inadvertent proximal reflux of the embolysate in pericallosal artery. This was safely and effectively rescued using a stent retriever manoeuvre, following similar principles and tenets as in endovascular thrombectomy in stroke. This is the first case report of using a newer smaller 3 mm stentriever in a paediatric medium vessel occlusion, although for a different aetiology but with the same goal.<\/jats:p>\n               <jats:p>Bail-out or rescue strategy as presented here is an important addition to neurointerventionalists\u2019 armamentarium to salvage a non-targeted migration of liquid embolic agent.<\/jats:p>","DOI":"10.1136\/bcr-2023-258422","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T12:00:12Z","timestamp":1724068812000},"page":"e258422","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Retrieval of refluxed Onyx cast during a paediatric AVM embolisation"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5754-9270","authenticated-orcid":false,"given":"Kislay","family":"Kishore","sequence":"first","affiliation":[{"name":"Neurosurgery and Neurointerventional Surgery, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"van Adel","sequence":"additional","affiliation":[{"name":"Neurosurgery and Neurointerventional Surgery, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"2025082700515388000_17.8.e258422.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-021-01066-6"},{"key":"2025082700515388000_17.8.e258422.2","first-page":"518","article-title":"Nidal embolization of brain arteriovenous malformations using Onyx in 94 patients","volume":"28","author":"Mounayer","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082700515388000_17.8.e258422.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2013.10.001"},{"key":"2025082700515388000_17.8.e258422.4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.wneu.2018.07.171","article-title":"Novel Use of Pipeline Stent Device After Inadvertent Microcatheter Rupture During Arteriovenous Fistula Embolization","volume":"119","author":"Cuellar","year":"2018","journal-title":"World Neurosurg"},{"key":"2025082700515388000_17.8.e258422.5","first-page":"173","article-title":"Rescue N-butyl-2 cyanoacrylate embolectomy using a Solitaire FR device after venous glue migration during arteriovenous malformation embolization: technical note","volume":"125","author":"Fahed","year":"2016","journal-title":"J N S"},{"key":"2025082700515388000_17.8.e258422.6","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s12028-009-9272-2","article-title":"Revasc of Onyx ind intra-op occl of vertebro-basilar art using Merci dev","volume":"12","author":"Michael","year":"2012","journal-title":"Neurocrit Care"},{"key":"2025082700515388000_17.8.e258422.7","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1007\/s00270-015-1095-2","article-title":"Mechanical Removal of Migrated Onyx Due to Microcatheter Rupture During AVM Embolization: a Technical Case Report","volume":"38","author":"Senturk","year":"2015","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025082700515388000_17.8.e258422.8","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1177\/1591019917694022","article-title":"Mechanical removal of a refluxed Onyx piece from the middle cerebral artery using the Solitaire Stent: technical report","volume":"23","author":"Gungor","year":"2017","journal-title":"Interv Neuroradiol"},{"key":"2025082700515388000_17.8.e258422.9","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.jvir.2015.01.024","article-title":"Liquid Embolic Onyx Reflux to Basilar Artery Retrieved by Solitaire AB Stent in the Treatment of Arteriovenous Malformations","volume":"26","author":"Li","year":"2015","journal-title":"J Vasc Interv Radiol"},{"key":"2025082700515388000_17.8.e258422.10","first-page":"558","article-title":"Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series","volume":"24","author":"Bhatia","year":"2019","journal-title":"J Neurosurg"},{"key":"2025082700515388000_17.8.e258422.11","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010044"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:52:05Z","timestamp":1756281125000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,19]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bcr-2023-258422"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258422","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}