Kim Jason, Li Yiping, Dawkins Demi, Ahmed Azam
University of Wisconsin, Madison, Wisconsin, USA.
Department of Neurological Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
World Neurosurg. 2018 Aug;116:214-218. doi: 10.1016/j.wneu.2018.05.106. Epub 2018 May 23.
Embolic 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.
We 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.
Knowledge 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.
栓塞性中风主要源于心脏或血管，但也有因医源性异物导致的情况。导管涂层或残留微导管主要与神经血管内介入术后的异物栓塞有关。然而，文献中尚无关于游离和/或移位微导管碎片的描述。
我们报告了一名69岁女性的临床细节、影像学表现及治疗情况，该患者接受了右侧眼旁动脉偶然发现的动脉瘤的择期管道栓塞术，并在神经血管内介入治疗期间，来自远端引导导管（088 Neuron Max，Penumbra，美国加利福尼亚州阿拉米达）的不透射线标记物发生远端栓塞。据我们所知，这是首例因神经介入导管无端断裂导致远端栓塞的报道病例。
了解多种挽救技术对于预防重大脑血管并发症至关重要。治疗异物栓塞时必须采取多层面方法。
