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  • Title: Snaring of a Glued Microcatheter During Embolization of an Arteriovenous Malformation with N-Butyl Cyanoacrylate.
    Author: Dahl RH, Holtmannspötter M, Gutte H, Cortsen M, Hauerberg J, Benndorf G.
    Journal: World Neurosurg; 2018 Dec; 120():343-348. PubMed ID: 30149156.
    Abstract:
    BACKGROUND: Microcatheter entrapment during embolization of brain arteriovenous malformations (AVMs) represents a potentially harmful technical complication. Although several techniques have been reported for endovascular catheter retrieval from an Onyx cast, such methods have never been demonstrated with acrylic glues. We report a case of removal of a glued microcatheter from an N-butyl cyanoacrylate (NBCA) cast using a microsnare. METHODS AND RESULTS: A 26-year-old woman presented with an intracranial hemorrhage resulting from a ruptured right choroidal AVM. A microcatheter used for transarterial embolization was unintentionally glued into the NBCA cast. Because attempts to remove the catheter by simple traction failed, a microsnare was used and allowed withdrawal of the entrapped microcatheter without causing damage to the cerebral vasculature. The patient woke up without clinical sequelae. CONCLUSIONS: Although it is not recommended as routine practice, snaring a glued microcatheter is feasible and can be used in selected cases as a last resort if thromboembolic complications are feared.
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