Endovascular Thrombectomy for Distal Occlusion Using a Semi-Deployed Stentriever: Report of 2 Cases and Technical Note
10.5469/neuroint.2019.00143
- Author:
Yue WAN
1
;
I Hsiao YANG
;
Emanuele ORRU
;
Timo KRINGS
;
Anderson Chun On TSANG
Author Information
1. Department of Neurology, The Third People’s Hospital of Hubei, Wuhan, China.
- Publication Type:Case Report
- Keywords:
Thrombectomy;
Stroke;
Endovascular procedures
- MeSH:
Arteries;
Endovascular Procedures;
Hemiplegia;
Lacerations;
Middle Cerebral Artery;
Stents;
Stroke;
Thrombectomy;
Traction
- From:Neurointervention
2019;14(2):137-141
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
