Temporary stent fixation combined with craniotomy for managing microcatheter fracture during cerebral AVM...

A 54-year-old male patient presented with impaired consciousness and weakness of the right limbs, and was clinically diagnosed with ruptured cerebral arteriovenous malformation(AVM), thus undergoing endovascular embolization. During the operation, the embolic microcatheter fractured, with its residual segment retained in the left posterior cerebral artery and basilar artery. To prevent migration of the residual catheter segment that may lead to secondary embolism or hemorrhage, a 6 × 30 mm stent was urgently deployed intraoperatively to fix the proximal end of the catheter. An immediate craniotomy was then performed to completely remove the fractured microcatheter residual segment, the stent was retrieved via the interventional sheath simultaneously, and the AVM lesion was radically resected. The patient recovered smoothly after surgery without relevant complications, and follow-up cranial CTA showed no residual AVM or vascular stenosis. The comprehensive approach of temporary stent fixation combined with craniotomy removal adopted in this case effectively avoided the risk of secondary hemorrhage caused by long-term dual antiplatelet therapy, and prevented embolism due to secondary fracture of the catheter residual segment, providing a valuable practical reference for the clinical management of such rare complications.