Mechanical Thrombectomy Using the Solitaire FR system for Occlusion of the Top of the Basilar Artery: Intentional Detachment of the Device after Partial Retrieval
Neurointervention 2014³â 9±Ç 1È£ p.26 ~ p.31
(Siu Kwong Lok) - Tuen Mun Hospital Department of Radiology
À̵¿±Ù(Lee Dong-Geun) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
½ÉÀçÈ£(Shim Jae-Ho) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
¼´ëö(Suh Dae-Chul) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
ÀÌ´öÈñ(Lee Deok-Hee) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
Abstract
Acute, distal, basilar artery occlusion is a challenging neurovascular emergency. There have been several reports regarding the successful application of the Solitaire FR device for treating this lesion. However, due to the lack of a suitable, balloon-tipped, guiding catheter for the vertebral artery, during this procedure we frequently experience the occurrence of clot fragmentation and distal migration. There may be some technical solutions to solve this problem. The purpose of this report is to present a technical variation of using the Solitaire FR, and which is referred to as the ¡¯intentional device detachment technique.¡¯ As a clot tends to re-embolize during its passage through the tortuous cranio-cervical junction level of the vertebral artery or its passage through the tip of the guiding catheter, due to the lack of proximal flow arrest, we thought that not removing the stent segment of the device which is capturing the clot could avoid this problem. We were able to successfully apply this technique in two cases. We believe that this technique can be a possible technical option for using the Solitaire FR device when a patient has little concern regarding the subsequent use of antiplatelets.
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Stroke/therapy, Basilar artery, Mechanical thrombolysis, Stent retriever
KMID :
1155820140090010026
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