Nishiyama Hirokazu, Matsumoto Hiroyuki, Izawa Daisuke, Toki Naotsugu
Department of Neurological Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
J Neuroendovasc Ther. 2021;15(1):58-63. doi: 10.5797/jnet.cr.2019-0107. Epub 2020 Sep 9.
We report renal artery injury by a guidewire during coil embolization of a cerebral artery aneurysm, which was successfully treated by transarterial embolization using n-butyl-2-cianoacrylate (NBCA).
A 65-year-old woman underwent coil embolization for an unruptured cerebral aneurysm, resulting in its complete occlusion. However, her blood pressure decreased during embolization and postoperative abdominal computed tomography (CT) revealed a retroperitoneal hematoma. Intraoperative video revealed that the 0.035-inch guidewire had passed deeply into the right renal artery when the guiding sheath was navigated into the abdominal aorta, suggesting renal artery perforation. Transarterial embolization using NBCA was performed immediately, which resulted in hemostasis.
Although renal artery perforation with a guidewire is a rare complication, it can have severe consequences. Early diagnosis with prompt and definitive hemostasis is important.
我们报告了在脑动脉瘤弹簧圈栓塞过程中导丝导致的肾动脉损伤，该损伤通过使用正丁基-2-氰基丙烯酸酯（NBCA）经动脉栓塞成功治疗。
一名65岁女性因未破裂脑动脉瘤接受弹簧圈栓塞，动脉瘤完全闭塞。然而，栓塞过程中她的血压下降，术后腹部计算机断层扫描（CT）显示腹膜后血肿。术中视频显示，当引导鞘管进入腹主动脉时，0.035英寸的导丝已深深进入右肾动脉，提示肾动脉穿孔。立即使用NBCA进行经动脉栓塞，实现了止血。
尽管导丝导致肾动脉穿孔是一种罕见的并发症，但可能产生严重后果。早期诊断并迅速进行确切止血很重要。
