• Jason Kim, Yiping Li, Demi Dawkins, and Azam Ahmed.
• University of Wisconsin, Madison, Wisconsin, USA.
• World Neurosurg. 2018 Aug 1; 116: 214-218.

BackgroundEmbolic strokes mainly result from cardiac or vascular origins, but there are instances when they can arise from iatrogenic foreign bodies. Catheter coatings or retained microcatheters are mainly implicated in foreign body embolism following neuroendovascular intervention. However, there are no known descriptions for free-floating and/or dislodged microcatheter fragments in the literature.Case DescriptionWe report the clinical details, imaging findings, and management of a 69-year-old woman who underwent elective pipeline embolization of an incidental right paraophthalmic artery aneurysm and suffered distal embolization of the radiopaque marker from a distal guide catheter (088 Neuron Max, Penumbra, Alameda, California, USA) used during neuroendovascular intervention. To the best of our knowledge, this is the first reported case of distal embolism from an unprovoked fracture of a neurointerventional catheter.ConclusionsKnowledge of several salvage techniques is essential in preventing major cerebrovascular complications. It is imperative that a multilevel approach should be taken when treating foreign body embolism.Copyright © 2018 Elsevier Inc. All rights reserved.

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