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 nav...

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Bibliographic Details
Published in:Journal of neuroradiology 2023-11, Vol.50 (6), p.600
Main Authors: Zur, Gil, Diouf, Ange, Fageeh, Areej, Drake, Brian, dos Santos, Marlise P, Lesiuk, Howard, Fahed, Robert
Format: Article
Language:English
Subjects:
Bailout
Fistula
Snare
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Summary: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)
ISSN:0150-9861
DOI:10.1016/j.neurad.2023.08.009