Jagani Manoj, Do Huy M, Heit Jeremy J
1 Mayo Clinic Medical School, Rochester, USA.
2 Department of Radiology, Neuroimaging and Neurointervention Division, 10623 Stanford University Medical Center , Stanford, USA.
Interv Neuroradiol. 2018 Feb;24(1):106-110. doi: 10.1177/1591019917737734. Epub 2017 Nov 10.
Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microcatheter fracture that resulted in a retained foreign body and an endovascular salvage maneuver. Case description An elderly patient presented with an acute ischemic stroke due to a severe stenosis in the proximal left middle cerebral artery (MCA). The patient failed non-invasive medical treatment and underwent endovascular treatment with angioplasty and Wingspan stent placement. Following Wingspan stent deployment, the stent delivery catheter fractured, and the retained catheter fragment resulted in MCA occlusion. The foreign body was retrieved by balloon catheter inflation within an intermediate catheter adjacent to the proximal end of the fractured catheter and removal of the entire construct (TRAP technique). Conclusions Wingspan delivery microcatheter fracture is a rare event. The TRAP technique may be used for successful retrieval of a retained foreign body.
颅内动脉粥样硬化疾病可能导致缺血性梗死，并且尽管进行了药物治疗，复发性缺血性中风的发生率仍很高。药物治疗失败的患者可能会接受脑动脉血管成形术及可能的Wingspan支架置入的血管内治疗。我们报告了一例独特的Wingspan输送微导管断裂病例，该病例导致异物残留并采取了血管内挽救措施。病例描述：一名老年患者因左大脑中动脉（MCA）近端严重狭窄出现急性缺血性中风。该患者无创药物治疗失败，接受了血管成形术及Wingspan支架置入的血管内治疗。在Wingspan支架展开后，支架输送导管断裂，残留的导管碎片导致MCA闭塞。通过在与断裂导管近端相邻的中间导管内充盈球囊导管并取出整个结构（TRAP技术）来取出异物。结论：Wingspan输送微导管断裂是一种罕见事件。TRAP技术可用于成功取出残留异物。
