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COMPLICATIONS RELATED TO MICROCATHETERS DURING ENDOVASCULAR TREATMENT OF BRAIN ARTERIOVENOUS MALFORMATIONS: TWO CASE REPORTS AND LITERATURE REVIEW
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Abstract
Objective: To report two rare complications related to microcatheters during endovascular embolization for brain arteriovenous malformations (AVMs), including microcatheter entrapment and microcatheter rupture leading to escape of embolic material into the cerebral circulation. We also review the literature regarding similar complications and management strategies. Methods: We describe the clinical course and management of two patients and compare them with published reports. Results: Case 1: A patient experienced microcatheter entrapment due to refluxed Onyx during embolization of a ruptured cerebellar AVM. The AVM was subsequently resected microsurgically, and the entrapped microcatheter was successfully removed during surgery. Case 2: A patient suffered microcatheter rupture during NBCA glue embolization of a ruptured periventricular AVM, resulting in glue migration into the cerebral arterial system. This complication was promptly managed with mechanical thrombectomy, restoring cerebral circulation. Conclusion: Although uncommon, microcatheter-related complications during AVM embolization can lead to severe outcomes. Management must be individualized depending on the clinical scenario. Our two cases highlight the importance of a multimodal approach: microsurgery may be used to remove a catheter trapped within the lesion, and endovascular mechanical intervention can effectively retrieve migrated embolic material from cerebral vessels.
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Keywords
Brain arteriovenous malformation (AVM); endovascular embolization; endovascular complications; microcatheter entrapment; microcatheter rupture.
References
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