A case report of onyx pulmonary arterial embolism contributing to hypoxemia during awake craniotomy for arteriovenous malformation resection

Brian T. Tolly, Jenna L. Kosky, Antoun Koht, Laura B. Hemmer*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Citations (Scopus)

Abstract

A healthy 26-year-old man with cerebral arteriovenous malformation underwent staged endovascular embolization with Onyx followed by awake craniotomy for resection. The perioperative course was complicated by tachycardia and severe intraoperative hypoxemia requiring significant oxygen supplementation. Postoperative chest computed tomography (CT) revealed hyperattenuating Onyx embolization material within the pulmonary vasculature, and an electrocardiogram indicated possible right heart strain, supporting clinically significant embolism. With awake arteriovenous malformation resection following adjunctive Onyx embolization becoming increasingly employed for lesions involving the eloquent cortex, anesthesiologists need to be aware of pulmonary migration of Onyx material as a potential contributor to significant perioperative hypoxemia.

Original languageEnglish (US)
Title of host publication100 Selected Case Reports from Anesthesia and Analgesia
PublisherWolters Kluwer Health
ISBN (Electronic)9781975115333
ISBN (Print)9781975115326
DOIs
StatePublished - Jan 1 2018

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Craniotomy
Arteriovenous Malformations
Pulmonary Embolism
Intracranial Arteriovenous Malformations
Lung
Embolism
Tachycardia
Electrocardiography
Thorax
Tomography
Oxygen
Hypoxia
Anesthesiologists

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "A healthy 26-year-old man with cerebral arteriovenous malformation underwent staged endovascular embolization with Onyx followed by awake craniotomy for resection. The perioperative course was complicated by tachycardia and severe intraoperative hypoxemia requiring significant oxygen supplementation. Postoperative chest computed tomography (CT) revealed hyperattenuating Onyx embolization material within the pulmonary vasculature, and an electrocardiogram indicated possible right heart strain, supporting clinically significant embolism. With awake arteriovenous malformation resection following adjunctive Onyx embolization becoming increasingly employed for lesions involving the eloquent cortex, anesthesiologists need to be aware of pulmonary migration of Onyx material as a potential contributor to significant perioperative hypoxemia.",
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A case report of onyx pulmonary arterial embolism contributing to hypoxemia during awake craniotomy for arteriovenous malformation resection. / Tolly, Brian T.; Kosky, Jenna L.; Koht, Antoun; Hemmer, Laura B.

100 Selected Case Reports from Anesthesia and Analgesia. Wolters Kluwer Health, 2018.

Research output: Chapter in Book/Report/Conference proceedingChapter

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