Figure 1.

Pull-push-pull technique. (a) After Onyx embolization, gentle retraction is applied to the Marathon microcatheter. Usually, retrieval of the catheter can be achieved at this point but if there is reflux of Onyx, the catheter can be entrapped. (b) Continue gentle retraction as one would with regular retrieval and notice the stretching of the Onyx solution. This will increase the surface area thereby promoting more cohesive properties of the Onyx cast. (c) Push the tip towards the original site of embolization and back a few millimeters into the proximal cast. (d) One can then pull/retract the catheter with improved catheter retrieval. Repeat the steps as necessary.