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E-248 Surgical removal of a glued microcatheter during embolization of an arteriovenous malformation with n-butyl cyanoacrylate

neurintsurg · 2026-07-19 · canonical JSON source

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Retained microcatheter is a rare complication during embolization of arteriovenous malformations (AVMs). Following the availability and popularization of Onyx, the incidence of retained catheter has become lesser. Though there have been reports of retained microcatheter during embolization of AVM with n-butyl cyanoacrylate. We report a case of surgical & endovascular removal of a glued microcatheter during embolization of an arteriovenous malformation with n-butyl cyanoacrylate. A 70-year-old male presented with an intracranial hemorrhage resulting a ruptured Rt insular AVM. A microcatheter used for trans-arterial embolization was unintentionally glued into the NBCA cast (15%) with parent artery glue without occlusion. Because attempts to remove the catheter by simple traction failed, we decide to leave on site. At that time, we didn’t try snare retrieval of a microcatheter. And we planned surgical removal of a microcatheter during AVM surgery on next day. Systemic heparin was maintained until surgery after embolization. Three days later, after removing the AVM nidus, the incision was applied to the MCA M1 trunk to remove the retained microcatheter during surgery, and after resection, the attempt was made to retrial, but it was not pulled out. Eventually, the microcatheter tip was placed in the MCA M1 proximal segment, and the operation was completed. We failed to remove a microcatheter during surgery finally. A few days later, it is removed using a large snare through a transfemoral artery approach.Disclosures S. Sheen: None.