Fellows’ Journal Club
October 2014
(2 of 3)
These authors present MR images in 7 patients who developed enhancing lesions after endovascular therapy for intracranial aneurysms, 3 of which were symptomatic. The number of lesions increased in 2, was stable in 1, decreased in 3, and disappeared in 1 patient. The authorsput forward that the imaging and clinical characteristics suggested a foreign body reaction. They found no correlation to a specific device, but a possible source may be the generic hydrophilic coating.
Summary
Complications of endovascular therapy of aneurysms mainly include aneurysm rupture and thromboembolic events. The widespread use of MR imaging for follow-up of these patients revealed various nonvascular complications such as aseptic meningitis, hydrocephalus, and perianeurysmal brain edema. We present 7 patients from 5 different institutions that developed MR imaging–enhancing brain lesions after endovascular therapy of aneurysms, detected after a median time of 63 days. The number of lesions ranged from 4–46 (median of 10.5), sized 2–20 mm, and were mostly in the same vascular territory used for access. Three patients presented with symptoms attributable to these lesions. After a median follow-up of 21.5 months, the number of lesions increased in 2, was stable in 1, decreased in 3, and disappeared in 1. The imaging and clinical characteristics suggested a foreign body reaction. We could find no correlation to a specific device, but a possible source may be the generic hydrophilic coating.
