• World Neurosurg · Aug 2020

    Review Case Reports

    Delayed fragmentation and distal embolisation of retained microcatheter causing lower limb ischaemia: A case report and review of the literature.

    • Monish M Maharaj, Rakesh Biju, Manar Khashram, and Zakier Hussain.
    • Department of Neurosurgery, Waikato Hospital, Hamilton, New Zealand; Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand; Faculty of Medicine, The University of Auckland, Auckland, New Zealand. Electronic address: monish.maharaj@gmail.com.
    • World Neurosurg. 2020 Aug 1; 140: 369-373.

    BackgroundEndovascular microcatheter adherence and retention is an uncommon complication during brain arteriovenous malformation (AVM) embolization with glue or ethylene-vinyl alcohol copolymer that has previously reported, although there are sparse reports of symptomatic complications thereafter.Case DescriptionWe present a unique complication 6 years after initial embolization of a cerebral AVM. The patient presented with acute lower limb insufficiency with computed tomography angiogram revealing fragmentation of the microcatheter and associated popliteal aneurysm. The patient underwent an emergency grafting and removal of the retained fragment and recovered without deficit postoperatively.ConclusionsFragmentation over retained microcatheters remains a concern that may be worth monitoring in the long term, although there are no recommendations for timing.Copyright © 2020 Elsevier Inc. All rights reserved.

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