Iatrogenic pseudoaneurysm of the middle meningeal artery during embolization of bilateral chronic subdural hematomas.

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-06-07 DOI:10.1177/15910199221107250

Z. Wilseck, Adam A Khan, N. Chaudhary, J. Gemmete

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引用次数: 1

Abstract

Summary/AbstractMiddle meningeal artery embolization has become an important treatment option for chronic subdural hematomas. While the treatment is safe, we present a unique case of development of an iatrogenic middle meningeal artery pseudoaneurysm during endovascular embolization with use of a dual-lumen balloon catheter used for injection of a liquid embolic agent. A 62-year-old man on Coumadin for portal vein thrombosis presented to the hospital with headache and supratherapeutic INR. Imaging revealed bilateral acute on chronic subdural hematomas. Given his medical comorbidities he underwent endovascular middle meningeal artery embolization. During the embolization, angiography revealed a pseudoaneurysm of the middle meningeal artery related to use of a dual-lumen balloon catheter. This pseudoaneurysm was successfully treated with ethylene vinyl alcohol embolization. Intracranial pseudoaneurysm related to balloon catheter use is a rare cause of iatrogenic pseudoaneurysm and could lead to life-threatening intracranial bleeding. Therefore, recognition and timely treatment are important.

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双侧慢性硬膜下血肿栓塞术中脑膜中动脉的医源性假性动脉瘤。

摘要脑膜中动脉栓塞术已成为慢性硬膜下血肿的重要治疗手段。虽然治疗是安全的，但我们提出了一个独特的病例，在使用双腔球囊导管注射液体栓塞剂进行血管内栓塞时，发生了医源性脑膜中动脉假性动脉瘤。一名62岁男子因门静脉血栓而服用香豆丁，因头痛和超治疗性INR而入院。影像显示双侧急性上慢性硬膜下血肿。鉴于他的医学合并症，他接受了血管内脑膜中动脉栓塞术。栓塞期间，血管造影显示脑膜中动脉假性动脉瘤与双腔球囊导管的使用有关。假性动脉瘤用乙烯乙基酒精栓塞成功治疗。颅内假性动脉瘤是一种罕见的医源性假性动脉瘤，可导致危及生命的颅内出血。因此，识别和及时治疗是很重要的。

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Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

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