Unexpected Detachment of Solitaire Stents during Mechanical Thrombectomy.
10.3340/jkns.2014.56.6.463
- Author:
Sung Tae KIM
1
;
Sung Chul JIN
;
Hae Woong JEONG
;
Jung Hwa SEO
;
Sam Yeol HA
;
Hae Wook PYUN
Author Information
1. Department of Neurosurgery, Busan Paik Hospital, Inje University, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Stroke;
Thrombectomy;
Stents
- MeSH:
Aged;
Carotid Artery, Internal;
Humans;
Middle Cerebral Artery;
Retrospective Studies;
Stents*;
Stroke;
Thrombectomy*
- From:Journal of Korean Neurosurgical Society
2014;56(6):463-468
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Unexpected Solitaire stent detachment can occur during mechanical Solitaire thrombectomy. The purpose of this study was to retrospectively evaluate the influencing factors causing unexpected Solitaire stent detachment and the clinical outcomes. METHODS: Between October 2011 to December 2013, 232 cases of mechanical Solitaire thrombectomy for acute ischemic stroke were performed in 3 stroke centers. During this period, we encountered unexpected Solitaire stent detachments during mechanical Solitaire thrombectomies in 9 cases. RESULTS: Solitaire stents unexpectedly detached in 9 cases (3.9%) during the retrieval of Solitaire stents. The median patient age was 76 years. The occlusion sites of the unexpected stent detachment were the proximal middle cerebral artery (MCA) in 7 cases and the internal carotid artery in 2 cases. The sizes of the stents that unexpectedly detached were 6x30 mm in 7 cases, 5x30 mm in 1 case, and 4x20 mm in 1 case. Four patients had unexpected detachment at the first retrieval, 1 patient at the second, 3 patients at the third, and 1 patient at the fifth. In all of the cases of unexpected detachment at the first retrieval, the stent deployment site was the proximal MCA. After detachment, a proximal marker of the Solitaire stent was observed in 3 patients. However, no marker was visible in the remaining 6 patients. CONCLUSION: Unexpected Solitaire stent detachment should be considered in the first instance of stent retrieval for a relatively large-diameter stent, especially in elderly patients with MCA occlusions.
