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Mechanical Thrombectomy of Acutely Occluded Flow Diverters.

Publication ,  Journal Article
Samaniego, EA; Dandapat, S; Roa, JA; Zanaty, M; Nakagawa, D; Hasan, DM
Published in: Oper Neurosurg (Hagerstown)
November 1, 2019

BACKGROUND: Embolization of intracranial aneurysms with the pipeline embolization device (PED; Medtronic, Dublin, Ireland) is a widely used technique. Despite adequate dual antiplatelet therapy and intraprocedural anticoagulation, in-stent thrombosis has been described. There is limited evidence for best management of this complication. OBJECTIVE: To describe in detail the technique used to perform thrombectomy of a recently placed PED with in-stent thrombosis. The aim of the procedure is to leave the PED in place and only perform thrombectomy of the luminal clot. METHODS: We describe two cases of successful thrombectomy with a stentriever of acutely occluded PEDs. A total of 2 patients underwent PED embolization of 2 previously clipped aneurysms. Despite optimal deployment of the PEDs and excellent angiographic results, both patients developed symptoms of right hemispheric stroke within 1 h of the procedure. A thrombectomy was performed in each patient with the stentriever within the newly deployed PED. Thrombectomy was successful and there was no evidence of PED displacement of vascular injury. RESULTS: Stentriever thrombectomy of intraluminal clot can be performed effectively when the entire stentriever device is deployed within the PED. We did not experience any PED displacement, vessel damage, spasm, or device malfunction using this technique. CONCLUSION: We report the use of a stentriever to perform thrombectomy for in-stent thrombosis after PED placement as an additional treatment option of acute occlusion. This technique has not been previously described.

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Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

November 1, 2019

Volume

17

Issue

5

Start / End Page

491 / 496

Location

United States

Related Subject Headings

  • Thrombosis
  • Thrombectomy
  • Subarachnoid Hemorrhage
  • Stents
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Female
  • Embolization, Therapeutic
 

Citation

APA
Chicago
ICMJE
MLA
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Samaniego, E. A., Dandapat, S., Roa, J. A., Zanaty, M., Nakagawa, D., & Hasan, D. M. (2019). Mechanical Thrombectomy of Acutely Occluded Flow Diverters. Oper Neurosurg (Hagerstown), 17(5), 491–496. https://doi.org/10.1093/ons/opz023
Samaniego, Edgar A., Sudeepta Dandapat, Jorge A. Roa, Mario Zanaty, Daichi Nakagawa, and David M. Hasan. “Mechanical Thrombectomy of Acutely Occluded Flow Diverters.Oper Neurosurg (Hagerstown) 17, no. 5 (November 1, 2019): 491–96. https://doi.org/10.1093/ons/opz023.
Samaniego EA, Dandapat S, Roa JA, Zanaty M, Nakagawa D, Hasan DM. Mechanical Thrombectomy of Acutely Occluded Flow Diverters. Oper Neurosurg (Hagerstown). 2019 Nov 1;17(5):491–6.
Samaniego, Edgar A., et al. “Mechanical Thrombectomy of Acutely Occluded Flow Diverters.Oper Neurosurg (Hagerstown), vol. 17, no. 5, Nov. 2019, pp. 491–96. Pubmed, doi:10.1093/ons/opz023.
Samaniego EA, Dandapat S, Roa JA, Zanaty M, Nakagawa D, Hasan DM. Mechanical Thrombectomy of Acutely Occluded Flow Diverters. Oper Neurosurg (Hagerstown). 2019 Nov 1;17(5):491–496.
Journal cover image

Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

November 1, 2019

Volume

17

Issue

5

Start / End Page

491 / 496

Location

United States

Related Subject Headings

  • Thrombosis
  • Thrombectomy
  • Subarachnoid Hemorrhage
  • Stents
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Female
  • Embolization, Therapeutic