Difficult and Complicated Neurointerventions


Associate Professor of Radiology Head of Interventional Radiology Dept Shirz University of Medical Science, Shiraz, Iran



Embolization is widely performed to treat brain arteriovenous malformations, but little has been reported on factors contributing to complications
Endovascular procedures mostly performed with Liquid materials including:

preradiosurgical embolization,
sole endovascular treatment,
Complete or near-complete obliteration of brain arteriovenous malformations Procedure-related complications include:

hemorrhagic complications and
ischemic complications

Embolization of brain arteriovenous malformations in the infratentorial location is significantly associated with complications. Patients with complications due to endovascular procedures had worse clinical outcomes 30 days after the procedures than those without complications.
Endovascular coiling for intracranial aneurysms has become an accepted treatment with good clinical results and provides adequate protection against rebleeding and rupture of aneurysms. However, despite the experience, preparation, or skill of the physician, complicationsduringendovasculartreatmentstill occur. The main complications of endovascular coiling are: procedural aneurysmal perforations by the microcatheter, micro-guidewire, or coil, and thromboembolic events.
two most common complications, aneurysmal perforation  and  thromboembolism  during endovascular coiling, and how we can prevent or overcome these complications to achieve a satisfactory outcome.
the flow diverter has been become an important tool but a couple of complications including in stent thrombosis and jump and migration.