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Foreign material emboli following cerebral, cardiac, and peripheral catheterizations have been reported since the mid-1990s. Catheter coatings have been frequently implicated. The most recent surge of interest in this phenomenon within the neurointerventional community is associated with procedures using flow-diversion devices for the treatment of cerebral aneurysms. Following coil-supported Pipeline embolization in 4 cases and stent-supported coiling in 1, 5 patients developed multiple subcentimeter enhancing lesions, usually with surrounding edema and variable magnetic susceptibility in the vascular territories of the treated aneurysms. Conventional angiography findings were unrevealing. Laboratory work-up showed mild CSF protein elevation with no leukocytosis. Brain biopsy in 2 cases revealed granulomatous angiitis encasing foreign material, identical in stain appearance to a polyvinylpyrrolidone catheter coating. Corticosteroid administration typically produced clinical improvement. A heterogeneous radiographic and clinical courses was noted, with rise and fall in the number of enhancing lesions in 2 patients and persistence in others. The etiology may be related to widespread adoption of increasingly sophisticated catheterization techniques. |
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angiitis,granulomatous of CNS
angiography,neurologic complications with
brain biopsy
cerebral edema
cerebral edema,vasogenic
cerebral embolism
cerebral hypersensitivity, delayed
complications
embolism
endovascular therapy
foreign body reaction
iatrogenic neurologic disorders
magnetic susceptibility
microhemorrhage,intracerebral
MRI,abnormal
MRI,contrast enhanced
MRI,susceptibility weighted
neuroradiology,interventional
steroid therapy,CNS treatment and complications with
treatment of neurologic disorder
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