부산대학교 도서관

We report a case of possible contrast extravasation from a preexisting infected aneurysm distal to the occlusion after mechanical thrombectomy. In a 77-year-old woman with a history of infective endocarditis presenting with a cerebral infarction, a high-density area around a peripheral aneurysm distal to the occlusion was detected on head CT after mechanical thrombectomy. The patient underwent coil embolization for suspected hemorrhage from the aneurysm, which was eventually determined to be a contrast extravasation from a preexisting aneurysm associated with infective endocarditis into the surrounding tissues adhering to the aneurysm due to a past septic embolism. Contrast extravasation around the peripheral aneurysm after mechanical thrombectomy may be related to injection of contrast media through a microcatheter distal to the occlusion, cerebral ischemia, stagnation of contrast media in cerebral vessels, and aneurysm wall permeability to contrast media. Because the area around the peripheral aneurysm may appear as a high-density area on head CT due to the effect of using contrast media, the necessity of aneurysm embolization should be determined carefully on the basis of the clinical course, past images, and dual-energy CT findings.