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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1479375

Hydrophilic Polymer Coating Delamination during Neurointerventional Treatment after Microcatheter Withdrawal: Particulate Identification through Attenuated Total Reflection Fourier-Transform Infrared Spectroscopy

Provisionally accepted
Sebastian Johannes Müller Sebastian Johannes Müller 1,2*Pablo Albiña-Palmarola Pablo Albiña-Palmarola 1Stefan Konieczny Stefan Konieczny 3Gregor Manke Gregor Manke 4Sebastian Fischer Sebastian Fischer 5,6Hans Henkes Hans Henkes 1,7
  • 1 Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany
  • 2 Neuroradiologische Klinik, Universitätsklinikum Magdeburg, Magdeburg, Germany
  • 3 IFAS “Institut für Qualitätssicherung und angewandte Schadensanalyse” GmbH, Dortmund, Germany
  • 4 Euro-Labor GmbH “Institute for Failure Analysis and Materials Investigation”, Bochum, Germany
  • 5 Klinik für diagnostische und interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Knapp-schaftskrankenhaus Bochum Langendreer, Ruhr Universität Bochum, Bochum, Germany
  • 6 Klinik für Radiologie und Neuroradiologie, Klinikum Siegen, Siegen, Germany
  • 7 Universität Duisburg-Essen, Medizinische Fakultät, Universitätsklinikum Essen, Essen, Germany

The final, formatted version of the article will be published soon.

    Hydrophilic coating embolism (HCE) is a rare and underreported complication in neurointerventional practice that can lead to serious medical consequences. Two endovascular procedures were interrupted at our institution after a cloudy liquid content was observed inside the rotating hemostatic valves (RHV) during microcatheter withdrawal. In both cases, the same type of microcatheter (Prowler Select Plus) and RHV (Merit) were being used, and coating dislodgement was suspected. Attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR) was used to identify the nature of such debris and compared it to samples obtained from different parts of an unused microcatheter and RHV. In an independent second analysis, an in vitro simulation of the withdrawal maneuver was conducted, followed by ATR-FTIR analysis. During both in vivo and in vitro observations, the presence of polyvinylpyrrolidone, a hydrophilic polymer commonly used for intravascular devices manufacture, was confirmed inside the RHV, and its origin was traced back to the surface coating of the distal and middle portions of the Prowler Select Plus microcatheter. This constitutes the first clinical report where hydrophilic coating dislodgement is linked to the microcatheter withdrawal maneuver using a specific microcatheter type, further replicated in an in vitro setting.

    Keywords: polymer coating, hydrophilic coating embolization, endovascular treatment, Attenuated total reflection, Fourier-transform infrared spectroscopy, Microcatheter

    Received: 14 Aug 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Müller, Albiña-Palmarola, Konieczny, Manke, Fischer and Henkes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sebastian Johannes Müller, Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.