Background and Aims
As the recent advance of suction catheters in endovascular field, the use of manual aspiration thrombectomy for patients with hyperacute ischemic stroke with large vessel occlusion has increased. Although contrast leakage and subarachnoid hemorrhage have been reported during this kind of procedures, there was no report of pseudoaneurysm formation due to vessel injury by suction catheters.

Method
We present a case of 60-year-old woman who presented to our emergency room with dysarthria and left-sided weakness. She underwent suction thrombectomy 5 times using Penumbra suction catheter for acute middle cerebral artery (MCA) occlusion and significant contrast leakage occurred during the procedure. On follow-up angiogram on post-operative day 15, we found a pseudoaneurysm and we treated with detachable coil embolization.

Results
We experienced contrast leakage during repetitive suction thrombectomy for a patient with acute MCA occlusion that later became a significant pseudoaneurysm.

Conclusion
Neurosurgeons who perform suction thrombectomy should keep in mind the possibility of vessel injury that results in the formation of a pseudoaneurysm, especially at the branching site or tortuous segments.

PSEUDOANEURYSM FORMATION AFTER REPETITIVE SUCTION THROMBECTOMY USING A SUCTION CATHETER -CASE REPORT-