Intravascular polymer material after coil embolization of a giant cerebral aneurysm.

Abstract

We report the case of an 87-year-old female who died after coil embolization of an intracerebral giant aneurysm. Guglielmi detachable (Boston Scientific Neurovascular, Fremont, CA) and Matrix2 coils (Boston Scientific Neurovascular, Fremont, CA) were used during the procedure to occlude the surgically untreatable left supraclinoid carotid artery aneurysm. Postprocedure imaging studies showed scattered areas of acute infarct involving multiple bilateral vascular territories. Autopsy confirmed widespread infarction due to embolized foreign material, morphologically consistent with hydrophilic polymer originating from the coated Matrix coil and Terumo glidewire (Terumo Medical, Somerset, NJ). Polymer gel is now widely used on several medical devices for interventional procedures worldwide, and we suspect that risks associated with iatrogenic embolization of this substance are underrecognized.

• Authors: Rupal I Mehta, Rashi I Mehta, Michael C Fishbein, Orestes E Solis, Reza Jahan, Noriko Salamon, Harry V Vinters, William H Yong
• Journal: Human pathology (Hum Pathol) Vol. 40 Issue 12 Pg. 1803-7 (Dec 2009) ISSN: 1532-8392 [Electronic] United States
• PMID: 19716159 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Polymers

Topics

• Aged, 80 and over
• Carotid Artery Diseases (therapy)
• Cerebral Infarction (etiology, pathology)
• Coronary Artery Disease (complications)
• Embolization, Therapeutic (adverse effects)
• Fatal Outcome
• Female
• Heart Failure (complications)
• Humans
• Hypertension (complications)
• Intracranial Aneurysm (therapy)
• Peripheral Vascular Diseases (complications)
• Polymers (adverse effects)
• Prostheses and Implants (adverse effects)
• Renal Insufficiency, Chronic (complications)