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Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note

Distal intracranial occlusions can sometimes cause significant neurological deficits. Endovascular thrombectomy in these vessels may improve outcome but carry a higher risk of haemorrhagic complications due to the small calibre and tortuosity of the target vessel. We report two cases of isolated M2/...

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Autores principales: Wan, Yue, Yang, I-Hsiao, Orru, Emanuele, Krings, Timo, Tsang, Anderson Chun On
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Interventional Neuroradiology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736505/
https://www.ncbi.nlm.nih.gov/pubmed/31401819
http://dx.doi.org/10.5469/neuroint.2019.00143
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author Wan, Yue
Yang, I-Hsiao
Orru, Emanuele
Krings, Timo
Tsang, Anderson Chun On
author_facet Wan, Yue
Yang, I-Hsiao
Orru, Emanuele
Krings, Timo
Tsang, Anderson Chun On
author_sort Wan, Yue
collection PubMed
description Distal intracranial occlusions can sometimes cause significant neurological deficits. Endovascular thrombectomy in these vessels may improve outcome but carry a higher risk of haemorrhagic complications due to the small calibre and tortuosity of the target vessel. We report two cases of isolated M2/3 artery occlusion causing dense hemiplegia that was successfully treated with stent retrieval thrombectomy. A “semi-deployment technique” of a 3 mm stentriever was employed at the M2/3 bifurcation of the middle cerebral artery. Partial stent unsheathing allowed adequate clot engagement while avoiding excessive tension by the stent metal struts along the tortuous course of a distal vessel. Complete revascularization was achieved after first-pass of the stent retriever without complication, resulting in good clinical outcome in both cases. The described semi-deployment technique reduces the radial and tractional force exerted by the stentreiver on small branches, and may reduce the risk of vessel laceration or dissection in distal vessel thrombectomy.
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spelling pubmed-67365052019-09-19 Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note Wan, Yue Yang, I-Hsiao Orru, Emanuele Krings, Timo Tsang, Anderson Chun On Neurointervention Technical Note Distal intracranial occlusions can sometimes cause significant neurological deficits. Endovascular thrombectomy in these vessels may improve outcome but carry a higher risk of haemorrhagic complications due to the small calibre and tortuosity of the target vessel. We report two cases of isolated M2/3 artery occlusion causing dense hemiplegia that was successfully treated with stent retrieval thrombectomy. A “semi-deployment technique” of a 3 mm stentriever was employed at the M2/3 bifurcation of the middle cerebral artery. Partial stent unsheathing allowed adequate clot engagement while avoiding excessive tension by the stent metal struts along the tortuous course of a distal vessel. Complete revascularization was achieved after first-pass of the stent retriever without complication, resulting in good clinical outcome in both cases. The described semi-deployment technique reduces the radial and tractional force exerted by the stentreiver on small branches, and may reduce the risk of vessel laceration or dissection in distal vessel thrombectomy. Korean Society of Interventional Neuroradiology 2019-09 2019-08-12 /pmc/articles/PMC6736505/ /pubmed/31401819 http://dx.doi.org/10.5469/neuroint.2019.00143 Text en Copyright © 2019 Korean Society of Interventional Neuroradiology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Technical Note
Wan, Yue
Yang, I-Hsiao
Orru, Emanuele
Krings, Timo
Tsang, Anderson Chun On
Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title_full Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title_fullStr Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title_full_unstemmed Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title_short Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
title_sort endovascular thrombectomy for distal occlusion using a semi-deployed stentriever: report of 2 cases and technical note
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736505/
https://www.ncbi.nlm.nih.gov/pubmed/31401819
http://dx.doi.org/10.5469/neuroint.2019.00143
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