A Case of Anterior Choroidal Artery Occlusion Caused by Stuck of Microguidewire during Cerebral Aneurysm Embolization

• Published in: Journal of Neuroendovascular Therapy 2016, Vol.10(4), pp.206-211
• Main Authors: Katayama, Masateru, Sasao, Ryota, Inoue, Satoshi, Suga, Sadao
• Format: Article
• Language: English
• Subjects: anterior choroidal artery occlusion; coil embolization; microguidewire injury; unruptured cerebral aneurysm
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.cr.2016-0025

Objective: A case in which a microguidewire unintentionally entered the anterior choroidal artery and was trapped there during embolization of a cerebral aneurysm is reported.Case Presentations: A 69-year-old female was due to undergo coil embolization of an unruptured anterior communicating artery aneurysm under general anesthesia. After the microguidewire unintentionally entered the anterior choroidal artery, it became impossible to manipulate or withdraw it, and a craniotomy was performed to attempt its recovery. The microguidewire was seen at the origin of the left anterior choroidal artery through the vascular wall and was considered to have entered a “false” lumen. Its extraction under direct vision was impossible. Therefore, after clipping, the microguidewire was cut at the puncture site, and the stump was left subcutaneously. The patient developed cerebral infarction in the territory of the anterior choroidal artery and was transferred to another hospital after half a year. Seven years after surgery, no change was observed in the brain or at the puncture site.Conclusion: A microguidewire unintentionally entered the anterior choroidal artery during embolization of a cerebral aneurysm, caused arterial dissection, became irremovable, and induced cerebral infarction.