Distal to proximal snaring of a fractured microcatheter during dural AVF embolization

Detachable-tip microcatheters are frequently used for endovascular embolization of arteriovenous shunts. Occasionally, the detachable tip can break during navigation resulting in the loss of the microcatheter tip in a vessel, which can lead to thrombo-embolic complications and also limit further navigation into the vessel to complete treatment. We present a case of dural AV-fistula embolization that was complicated by the accidental detachment and loss of the tip of a microcatheter during navigation to injection site. The proximal tip of the broken catheter was not visible and therefore we were unable to capture its proximal part with a Snare. Ultimately, we navigated a microcatheter distal to the broken segment and successfully snared the microcatheter fragment retrogradely. (Video 1).