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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Intra-operative combustion of Onyx embolic material
S J Smith1, A Thomas, R D Ashpole
1Department of Neurosurgery, Queen's Medical Centre, Derby Road, Nottingham, UK. sjsmith@doctors.net.uk
British Journal of Neurosurgery
|February 24, 2009
Summary
Tantalum/Onyx embolic agents can dangerously combust when exposed to monopolar diathermy. Surgeons must exercise caution during surgical resection of previously embolized arteriovenous malformations to prevent this risk.
Area of Science:
- Interventional Radiology
- Neurosurgery
- Materials Science
Background:
- Arteriovenous malformations (AVMs) are complex vascular anomalies often treated with embolization.
- Tantalum/Onyx is a commonly used embolic agent for AVM treatment.
- Subsequent surgical intervention may be necessary for residual or recurrent AVMs.
Observation:
- A case of dangerous combustion involving Tantalum/Onyx embolic agent was observed.
- The combustion occurred during monopolar diathermy application.
- This happened during the surgical resection of a partially embolized AVM.
Findings:
- Monopolar diathermy poses a significant combustion risk when used with Tantalum/Onyx embolic agents.
- The presence of embolic material can alter the thermal properties during diathermy.
- This interaction can lead to unpredictable and hazardous events.
Implications:
- Surgeons must be aware of the potential for Tantalum/Onyx embolic agent combustion.
- Diathermy use requires careful consideration in patients with prior embolization.
- Alternative energy sources or techniques may be necessary to mitigate combustion risks during AVM resection.
