PT  - JOURNAL ARTICLE
AU  - M. Shapiro
AU  - M.D. Ollenschleger
AU  - C. Baccin
AU  - T. Becske
AU  - G.R. Spiegel
AU  - Y. Wang
AU  - X. Song
AU  - E. Raz
AU  - D. Zumofen
AU  - M. Potts
AU  - P.K. Nelson
TI  - Foreign Body Emboli following Cerebrovascular Interventions: Clinical, Radiographic, and Histopathologic Features
AID  - 10.3174/ajnr.A4415
DP  - 2015 Aug 20
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2015/08/20/ajnr.A4415.short
4100  - http://www.ajnr.org/content/early/2015/08/20/ajnr.A4415.full
AB  - SUMMARY: 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.AbbreviationsPRUP2Y12 reaction unitsPVPpolyvinylpyrrolidone