title: Foreign Body Emboli following Cerebrovascular Interventions: Clinical, Radiographic, and Histopathologic Features.
abstract: 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 course 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.
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.) Bernard and Irene Schwartz Neurointerventional Radiology Section, Neurology (M.S., T.B.) neuroangio@neuroangio.org.
authors: M
authors: M
authors: Shapiro
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.).
authors: M D
authors: MD
authors: Ollenschleger
authors: Department of Interventional Neuroradiology (C.B.), São Paulo, Brazil.
authors: C
authors: C
authors: Baccin
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.) Bernard and Irene Schwartz Neurointerventional Radiology Section, Neurology (M.S., T.B.).
authors: T
authors: T
authors: Becske
authors: Departments of Radiology (G.R.S.).
authors: G R
authors: GR
authors: Spiegel
authors: Department of Rheumatology (Y.W.), Grove Hill Medical Center and The Hospital of Central Connecticut, New Britain, Connecticut.
authors: Y
authors: Y
authors: Wang
authors: Pathology (X.S.), Hartford Hospital, Hartford, Connecticut.
authors: X
authors: X
authors: Song
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.).
authors: E
authors: E
authors: Raz
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.) Neurosurgery (D.Z. M.B.P., P.K.N.), New York University Langone Medical Center, New York University School of Medicine, New York, New York.
authors: D
authors: D
authors: Zumofen
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.) Neurosurgery (D.Z. M.B.P., P.K.N.), New York University Langone Medical Center, New York University School of Medicine, New York, New York.
authors: M B
authors: MB
authors: Potts
authors: From the Departments of Radiology (M.S., M.D.O., T.B., E.R., D.Z., M.B.P., P.K.N.) Neurosurgery (D.Z. M.B.P., P.K.N.), New York University Langone Medical Center, New York University School of Medicine, New York, New York.
authors: P K
authors: PK
authors: Nelson
mesh_terms: D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D057785:Catheters / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005547:Foreign Bodies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D020766:Intracranial Embolism / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents / Q000009:adverse effects