Parthasarathy Rajsrinivas, Gupta Vipul, Goel Gaurav, Mahajan Anshu
Department of Neurointerventional Surgery, Artemis Hospitals, Sector 51, Gurgaon, Haryana-122001.
Department of Neurointerventional Surgery, Medanta The Medicity, Gurgaon, Haryana, India.
BMJ Case Rep. 2016 Aug 12;2016:bcr2016012547. doi: 10.1136/bcr-2016-012547.
Solitaire FR stent-based mechanical thrombectomy provides clinical benefit in selected patients with acute ischaemic stroke due to large vessel occlusion. A dreaded device complication that is associated with poor technical and clinical outcome is stent detachment. Retrieval of the detached stent can be technically challenging and has been attempted with variable success. The key benefit of this strategy is the lack of need to administer fibrinolytic/antiplatelet agents that can potentially be catastrophic in the setting of acute stroke. Therefore, retrieval may be preferred to other strategies (balloon angioplasty, lytic/glycoprotein 2b/3a inhibitors administration) to address detached stent. We report two patients in whom the detached stent was retrieved using alternative techniques-'deploy and engage' and 'loop and snare'-as snare retrieval failed.
基于Solitaire FR支架的机械取栓术为因大血管闭塞导致急性缺血性卒中的特定患者带来了临床益处。与技术和临床结果不佳相关的一种可怕的器械并发症是支架脱离。取出脱离的支架在技术上具有挑战性，人们曾尝试过，成功率各不相同。该策略的关键优势在于无需使用在急性卒中情况下可能带来灾难性后果的纤溶/抗血小板药物。因此，相比于其他处理脱离支架的策略（球囊血管成形术、溶栓/糖蛋白2b/3a抑制剂给药），取出可能更受青睐。我们报告了两名患者，在圈套器取出失败后，使用“展开并接合”和“套圈并圈套”等替代技术成功取出了脱离的支架。
