Direct catheter redirection of a symptomatic errant intracranial Silastic sphere embolus.

A patient with an arteriovenous malformation experienced a severe neurologic deficit during preoperative particulate embolization with Silastic spheres. Angiography and radiography showed that one sphere had become lodged in a normal branch of the middle cerebral artery. After several unsuccessful attempts at dislodgment, a Tracker catheter system was advanced directly to the site of the sphere, and the sphere was successfully dislodged. The neurologic deficit cleared immediately, and the sphere was redirected to an artery feeding the malformation.