Intravascular polymer material after coil embolization of a giant cerebral aneurysm.
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.
Mehta
Rupal I
RI
Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA 90095, USA. rmehta@mednet.ucla.edu
Mehta
Rashi I
RI
Fishbein
Michael C
MC
Solis
Orestes E
OE
Jahan
Reza
R
Salamon
Noriko
N
Vinters
Harry V
HV
Yong
William H
WH
D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000628:therapy; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D003324:Coronary Artery Disease / Q000150:complications; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D002532:Intracranial Aneurysm / Q000628:therapy*; D016491:Peripheral Vascular Diseases / Q000150:complications; D011108:Polymers / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications
D011108:Polymers