Use of a second microcatheter in the management of a perforation during endovascular treatment of a cerebral aneurysm.

We describe the management of a perforation during endovascular treatment of a ruptured paraophthalmic aneurysm in a 53-year-old woman. The microcatheter and guidewire perforated the aneurysm during the initial catheterization. Using a second microcatheter, the aneurysm was packed with Guglielmi detachable coils while the first microcatheter was left in place. There were no adverse effects from the procedure, and the patient was discharged in good clinical condition.