• Kentaro Hayashi, Naoki Kitagawa, Minoru Morikawa, Yoichi Morofuji, Kazuhiko Suyama, and Izumi Nagata.
• Department of Neurosurgery, Nagasaki University School of Medicine, Japan.
• No Shinkei Geka. 2009 May 1; 37 (5): 485-90.

AbstractEndovascular embolization for a cerebrovascular lesion has been increasingly performed. We experienced disruption of the microcatheter during a cerebral aneurysm embolization and removed the catheter fragment with retrieval forceps. A 56-year-old woman was brought to our hospital because of consciousness disturbance. Radiological examination revealed subarachnoid hemorrhage due to the rupture of an anterior communicating artery aneurysm. Despite endovascular embolization and neck clipping of the aneurysm, the aneurysm recurred. Then, endovascular embolization was performed. During introduction of the microcatheter to the cerebral aneurysm, the microcatheter disrupted spontaneously at the center of the catheter and the distal end of the catheter migrated into the right middle cerebral artery. The proximal part of the catheter fragment was located at the common carotid artery bifurcation. An attempt to retrieve the catheter by snare failed. Then, retrieval forceps were navigated. The catheter fragment was caught at the common carotid artery bifurcation and successfully removed. Subsequently, the cerebral aneurysm was embolized with detachable coils. No additional complication occured. Microscopical observation of the catheter end revealed relatively sharp disruption and extension of the stainless steel blade. Microcatheter disruption and migration is a rare but significant complication of endovascular embolization. Percutaneous technique with retrieval forceps for the extraction of intravascular foreign objects was useful.

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