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Metallic Retinal Artery Embolus following Pipeline Embolization Device.

Colin P Froines¹, Samuel A Whittier, Justin L Gottlieb

¹Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison Wisconsin, USA.

Retinal Cases & Brief Reports

|September 23, 2025

Summary

A rare complication of Pipeline Embolization Device (PED) placement, a metallic retinal embolus, was found incidentally in an asymptomatic patient. This metallic embolus did not cause vascular occlusion, as confirmed by optical coherence tomography angiography.

Keywords:

flow diverting stent neurosurgery pipeline embolization device retinal embolus

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Area of Science:

Ophthalmology
Neurology
Interventional Radiology

Background:

Cerebral aneurysms are often treated with endovascular methods.
The Pipeline Embolization Device (PED) is a common tool for treating complex aneurysms.
Complications, though rare, require careful monitoring.

Purpose of the Study:

To report a case of asymptomatic metallic retinal embolus.
To describe this complication following Pipeline Embolization Device (PED) placement.
To highlight the diagnostic findings and implications.

Main Methods:

A case report of a 41-year-old female patient is presented.
The patient underwent two Pipeline Embolization Device (PED) placements for a left ophthalmic artery aneurysm.
Ophthalmological referral was made due to an incidentally discovered refractile object in the macula.

Main Results:

Fundoscopic examination revealed a refractile foreign body near the fovea.
Optical coherence tomography (OCT) confirmed the intravascular location of the object.
OCT angiography showed no evidence of vascular occlusion caused by the embolus.

Conclusions:

Metallic embolus is an infrequent complication associated with Pipeline Embolization Device (PED) procedures.
Early detection and monitoring are crucial for managing such rare complications.
This case underscores the importance of comprehensive post-procedural evaluation.