{
  "abstract": "Background and Purpose Cerebral air embolism is a rare but potentially serious complication of endovascular procedures. Intra-aneurysmal air entrapment during stent-assisted coil embolization is exceedingly uncommon, and optimal rescue strategies have not been well established. We report a case of intra-aneurysmal air entrapment successfully managed using microcatheter aspiration.Case Description A 69-year-old man with an unruptured anterior communicating artery aneurysm underwent stent-assisted coil embolization. On control angiography performed to obtain a working projection prior to coil embolization, a floating air bubble within the aneurysm sac was identified. At this time, it was noticed that large amount of air was present in the arterial flushing line. The flushing line and catheter were flushed immediately and cleared of air. Subsequent control angiography revealed intact large intracranial vessels; however, mildly delayed flow was noted in the ACA–MCA border zone. Given the potential risk of distal embolization and thromboembolic complications, an immediate rescue technique was performed. A microcatheter was carefully advanced into the aneurysm, and the intra-aneurysmal air was successfully aspirated. The embolization was subsequently completed without further complications. Postprocedurally, the patient experienced drowsy mentality with dense right-sided weakness for approximately 3 days, followed by gradual and complete neurologic recovery. Postprocedural MR imaging demonstrated no definite infarction in the left cerebral hemisphere, although mild time-to-peak delay was observed on perfusion imaging.Conclusions Intra-aneurysmal air entrapment can occur as a rare intraprocedural complication during stent-assisted coil embolization for unruptured intracranial aneurysms. Microcatheter aspiration is a simple and effective rescue technique for removing trapped air and may help prevent potentially serious thromboembolic events. Prompt recognition and immediate endovascular management are essential for safe procedural outcomes.Disclosures Y. Kim: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea, Republic of"
      ],
      "name": "Y Kim"
    }
  ],
  "title": "E-175 Rescue microcatheter aspiration of intra-aneurysmal air entrapment during stent-assisted coil embolization",
  "uid": "d2f2c63b-263d-5c92-909c-9653b0a08184"
}