• World Neurosurg · Dec 2018

    Case Reports

    Snaring of a glued microcatheter during embolization of an arteriovenous malformation with n-butyl cyanoacrylate: Technical report with review of literature (DRAFT).

    • Rasmus H Dahl, Markus Holtmannspötter, Henrik Gutte, Marie Cortsen, John Hauerberg, and Goetz Benndorf.
    • Department of Radiology, Neurovascular Section, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Neuroanaesthesiology, University Hospital Rigshospitalet, Copenhagen, Denmark.
    • World Neurosurg. 2018 Dec 1; 120: 343-348.

    BackgroundMicrocatheter entrapment during embolization of brain arteriovenous malformations (AVMs) represents a potentially harmful technical complication. Although several techniques have been reported for endovascular catheter retrieval from an Onyx cast, such methods have never been demonstrated with acrylic glues. We report a case of removal of a glued microcatheter from an N-butyl cyanoacrylate (NBCA) cast using a microsnare.Methods And ResultsA 26-year-old woman presented with an intracranial hemorrhage resulting from a ruptured right choroidal AVM. A microcatheter used for transarterial embolization was unintentionally glued into the NBCA cast. Because attempts to remove the catheter by simple traction failed, a microsnare was used and allowed withdrawal of the entrapped microcatheter without causing damage to the cerebral vasculature. The patient woke up without clinical sequelae.ConclusionsAlthough it is not recommended as routine practice, snaring a glued microcatheter is feasible and can be used in selected cases as a last resort if thromboembolic complications are feared.Copyright © 2018 Elsevier Inc. All rights reserved.

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