Hemodynamic Instability during Squid Embolization of Dural Arteriovenous Fistula: A Case Report

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...

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Bibliographic Details
Main Authors: Ehab Mahmoud, Osman Koc, Mostafa Mahmoud
Format: Article
Language:English
Published: Korean Society of Interventional Neuroradiology 2025-03-01
Series:Neurointervention
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Online Access:http://neurointervention.org/upload/pdf/neuroint-2024-00521.pdf
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Summary: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.
ISSN:2093-9043
2233-6273