Carotid Endarterectomy to Remove Retained Solitaire Stent Retriever inside Carotid Stent after Mechanical Thrombectomy.

Journal Article

Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important.A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot. On withdrawal, the tines of the Solitaire stent lodged inside the Precise carotid stent. The patient was started on aspirin, Plavix, and heparin infusion, and underwent a carotid endarterectomy (CEA) with safe removal of the stents and primary vessel repair.This is the first case reported to date of a Solitaire stent becoming lodged inside a Precise carotid stent, salvaged by CEA with safe removal of the stents and primary vessel repair. We discuss the timing, indication, alternatives, and technical nuances of a CEA in this setting.

Full Text

Duke Authors

Cited Authors

  • Cobb, MI-PH; Smith, TP; Brown, PA; Gonzalez, LF; Zomorodi, AR

Published Date

  • May 2017

Published In

Volume / Issue

  • 26 / 5

Start / End Page

  • e90 - e95

PubMed ID

  • 28318956

Electronic International Standard Serial Number (EISSN)

  • 1532-8511

International Standard Serial Number (ISSN)

  • 1052-3057

Digital Object Identifier (DOI)

  • 10.1016/j.jstrokecerebrovasdis.2017.02.015

Language

  • eng