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Delayed Fragmentation and Distal Embolization of Retained Microcatheter Causing Lower Limb Ischemia: Case Report and
Monish M Maharaj1, Rakesh Biju2, Manar Khashram3
1Department 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.
Background:
Endovascular 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 Description:
We 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.
Conclusions:
Fragmentation over retained microcatheters remains a concern that may be worth monitoring in the long term, although there are no recommendations for timing.
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