{
  "abstract": "Objective\n\nTo demonstrate that intraoperative motor-evoked potential (MEP) monitoring can detect angiographically occult perforator ischemia caused by intermediate catheter-induced luminal occupation and flow restriction during Woven EndoBridge (WEB; Terumo Neuro, Aliso Viejo, CA, USA) deployment, which would otherwise remain unrecognized.Case presentation\n\nA woman in her 60s underwent WEB deployment for an unruptured left middle cerebral artery aneurysm under general anesthesia with intraoperative MEP monitoring using an optimized transcranial electrical stimulation protocol. Immediately prior to device deployment, MEP amplitudes abruptly disappeared in the right extremities. DSA showed preserved lenticulostriate artery opacification; however, the M1 segment was nearly completely occupied by the intermediate catheter. Catheter-induced perforator ischemia was suspected, and the catheter was promptly withdrawn to the cavernous internal carotid artery. MEP signals fully recovered within approximately 4 minutes, and WEB deployment was completed without further incident. Postoperative MRI revealed a small lacunar infarction in the lenticulostriate territory, but the patient was discharged without neurological deficits.Conclusion\n\nIntermediate catheter-induced luminal occupation of the parent artery can cause angiographically occult perforator ischemia detectable only by functional monitoring. MEP monitoring may serve as a critical safeguard during WEB deployment and other neuroendovascular procedures involving large-bore intermediate catheters in perforator-rich arterial segments.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Sapporo Medical University, Sapporo, Hokkaido, Japan.",
    "Division of Clinical Engineering, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.",
    "Department of Neurosurgery, Muroran City General Hospital, Muroran, Hokkaido, Japan.",
    "Department of Neurosurgery, Shin-Sapporo Neurosurgical Hospital, Sapporo, Hokkaido, Japan."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yasuhiro Takahashi",
      "orcid": "0009-0009-0849-4344"
    },
    {
      "affs": [
        1
      ],
      "name": "Shoto Yamada"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuki Gotoh"
    },
    {
      "affs": [
        2
      ],
      "name": "Ryohei Saito"
    },
    {
      "affs": [
        3
      ],
      "name": "Chie Kamada"
    },
    {
      "affs": [
        0
      ],
      "name": "Ayumu Yamaoka"
    },
    {
      "affs": [
        0
      ],
      "name": "Sangnyon Kim"
    },
    {
      "affs": [
        0
      ],
      "name": "Yukinori Akiyama"
    },
    {
      "affs": [
        0
      ],
      "name": "Nobuhiro Mikuni"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cxgjs9z2k2fh5.bib",
  "cited_by": 0,
  "doi": "10.5797/jnet.cr.2026-0111",
  "fulltext_url": "https://europepmc.org/articles/PMC13724231",
  "id": "cxgjs9z2k2fh5",
  "issns": [
    "1882-4072",
    "2186-2494"
  ],
  "landing_url": "https://europepmc.org/article/MED/42969007",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2746|Intraoperative Neuromonitoring and Anesthetic Effects"
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  "openalex": "W7223841003",
  "pdf_url": "https://europepmc.org/articles/PMC13724231?pdf=render",
  "pmcid": "PMC13724231",
  "pmid": "42969007",
  "published": "2026-10-28",
  "publisher": "The Japanese Society for Neuroendovascular Therapy",
  "ris": "https://research.draconitic.com/paper/cxgjs9z2k2fh5.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42969007",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42969007"
    },
    {
      "first_seen": "2026-11-04T12:22:43Z",
      "native_id": "PMC13724231",
      "source": "pmc",
      "url": "https://doi.org/10.5797/jnet.cr.2026-0111"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Intraoperative Neuromonitoring and Anesthetic Effects",
      "subfield": "surgery"
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  ],
  "title": "Angiographically Occult Perforator Ischemia Detected by Motor-Evoked Potential Monitoring during Woven EndoBridge Deployment: A Case Report.",
  "title_text": "Angiographically Occult Perforator Ischemia Detected by Motor-Evoked Potential Monitoring during Woven EndoBridge Deployment: A Case Report.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:54Z",
  "url": "https://research.draconitic.com/paper/cxgjs9z2k2fh5",
  "venue": "Journal of neuroendovascular therapy",
  "versions": []
}