{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:35:48Z","timestamp":1759178148463,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2020,1,9]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Arteriovenous malformations (AVMs) are vascular lesions that may be treated by an endovascular approach using liquid embolic agents but the control of the liquid embolic agent remains poor and a potential complication may be distal migration of embolic material. The TIGERTRIEVER 13 is a new stent retriever designed for stroke thrombectomy and has a version ideal for distal occlusions. We report our experience in the removal of embolic agent which had migrated into the distal vessels using the TIGERTRIEVER during PHIL\/Onyx embolization of AVMs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical presentations<\/jats:title>\n                  <jats:p>Three patients with brain and spinal AVMs underwent endovascular embolization. During trans-arterial embolization of the AVM with PHIL\/Onyx, retrograde filling of distal arterial feeders was followed by migration into the normal arterial branches (cortical middle cerebral artery, distal posterior cerebral artery, and anterior spinal artery). This resulted in occlusion or sluggish distal flow in these branches with potential significant neurological deficits. In all three cases, a Headway Duo microcatheter was navigated distally in the occluded vessel beyond the embolic material using a Traxcess microwire. The TIGERTRIEVER 13 was deployed with recanalization of the vessel after a single attempt. In all three patients there were no complications related to the retrieval of embolic agent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Distal migrated embolic agents such as PHIL or Onyx can be removed from various arterial vascular territories using stent retrievers dedicated to small vessels.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2019-015474","type":"journal-article","created":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T17:19:30Z","timestamp":1580923170000},"page":"794-797","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Removal of distal fragments of liquid embolic agents during arteriovenous malformation embolization using the TIGERTRIEVER 13: a technical report"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-5958","authenticated-orcid":false,"given":"Faith LY","family":"Ho","sequence":"first","affiliation":[{"name":"Neurosurgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9","family":"Chapot","sequence":"additional","affiliation":[{"name":"Neuroradiology, Alfried Krupp Krankenhaus Ruttenscheid, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,5]]},"reference":[{"key":"2025092912550078000_12.8.794.1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2006.104.2.226"},{"key":"2025092912550078000_12.8.794.2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0793"},{"key":"2025092912550078000_12.8.794.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2010.09.024"},{"key":"2025092912550078000_12.8.794.4","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3643"},{"key":"2025092912550078000_12.8.794.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2013.10.001"},{"key":"2025092912550078000_12.8.794.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2013.08.001"},{"key":"2025092912550078000_12.8.794.7","doi-asserted-by":"crossref","unstructured":"Li M , Guo Q , Liu W , et al . Liquid embolic Onyx reflux to basilar artery retrieved by Solitaire AB stent in the treatment of arteriovenous malformations. JVIR 2015.","DOI":"10.1016\/j.jvir.2015.01.024"},{"key":"2025092912550078000_12.8.794.8","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":"2025092912550078000_12.8.794.9","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s12028-009-9272-2","article-title":"Revascularization of Onyx induced intra-operative occlusion of vertebro-basilar artery using the Merci device","volume":"12","author":"Michael","year":"2010","journal-title":"Neurocrit Care"},{"key":"2025092912550078000_12.8.794.10","doi-asserted-by":"crossref","first-page":"173","DOI":"10.3171\/2015.5.JNS15145","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 Neurosurg"},{"key":"2025092912550078000_12.8.794.11","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":"2025092912550078000_12.8.794.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"2025092912550078000_12.8.794.13","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3552"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2019-015474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T19:55:10Z","timestamp":1759175710000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2019-015474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,5]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,7,14]]},"published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1136\/neurintsurg-2019-015474"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2019-015474","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"type":"print","value":"1759-8478"},{"type":"electronic","value":"1759-8486"}],"subject":[],"published":{"date-parts":[[2020,2,5]]}}}