Document Detail

Extravasation during Aneurysm Embolization without Neurologic Consequences. Lessons learned from Complications of Pseudoaneurysm Coiling. Report of 2 Cases.
MedLine Citation:
PMID:  19096673     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Although endovascular intervention is the first-line treatment of intracranial aneurysm, intraprocedural rupture or extravasation is still an endangering event. We describe two interesting cases of extravasation during embolotherapy for ruptured peripheral cerebral pseudoaneurysms. Two male patients were admitted after development of sudden headache with presentation of intracerebral and subarachnoid hemorrhage, respectively. Initial angiographic assessment failed to uncover any aneurysmal dilatation in both patients. Two weeks afterwards, catheter angiography revealed aneurysms each in the peripheral middle cerebral artery and anterior inferior cerebellar artery. Under a general anesthesia, endovascular embolization was attempted without systemic heparinization. In each case, sudden extravasation was noted around the aneurysm during manual injection of contrast after microcatheter navigation. Immediate computed tomographic scan showed a large amount of contrast collection within the brain, but they tolerated and made an unremarkable recovery thereafter. Intraprocedural extravasation is an endangering event and needs prompt management, however proximal plugging with coil deployment can be sufficient alternative, if one confronts with peripheral pseudoaneurysm. Peculiar angiographic features are deemed attributable to extremely fragile, porous vascular wall of the pseudoaneurysm. Accordingly, it should be noted that extreme caution being needed to handle such a friable vascular lesion.
Yun Hee Hue; Hyeong-Joong Yi; Young-Joon Kim
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Publication Detail:
Type:  Journal Article     Date:  2008-09-30
Journal Detail:
Title:  Journal of Korean Neurosurgical Society     Volume:  44     ISSN:  2005-3711     ISO Abbreviation:  J Korean Neurosurg Soc     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-12-19     Completed Date:  2011-07-14     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  101467054     Medline TA:  J Korean Neurosurg Soc     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  178-81     Citation Subset:  -    
Department of Neurosurgery , Hanyang University Medical Center, Seoul, Korea.
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