Foreign body granuloma as a complication of endovascular treatment of brain aneurysm

Abstract

Objectives: To describe this uncommon but outstanding vascular post-treatment complication attributable to detached polymer coatings from intravascular medical devices employed in diagnostic or therapeutic procedures. Methods: In this retrospective study we report the cases of two patients who after endovascular procedures for brain aneurysms developed neurological onsets which required further radiological analysis. Results: In the Magnetic Resonance studies performed after the neurological attacks the patients developed multiple millimetric enhancing lesions in the vascular area of the procedure: Both patients underwent biopsy. The imaging findings and clinical course suggested foreign body reactions in both cases, this being histologically confirmed in one case by the presence of thread-like material compatible with a polymer coating. Conclusions: Fragments from polymer-coated devices used in intravascular procedures, including brain aneurysm treatment, may be released into the blood stream or treated aneurysm, occasionally causing foreign body granulomas, a complication we must be aware of to obtain an accurate diagnosis and indicate appropriate treatment.

Keywords

• Polymers
• Intracranial aneurysm
• Endovascular procedures