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Accidental guide catheter fracture in mechanical thrombectomy.

作者信息

Al-Schameri Abdul Rahman, Deshmukh Aviraj, Debaseh Hadi, Griessenauer Christoph, Killer-Oberpfalzer Monika

机构信息

1 Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria.

2 Neurology Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.

出版信息

Interv Neuroradiol. 2019 Jun;25(3):297-300. doi: 10.1177/1591019918814011. Epub 2018 Nov 21.

DOI:10.1177/1591019918814011
PMID:30463502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6547217/
Abstract

Endovascular thrombectomy is now the standard of care for large vessel occlusion stroke. The aim is to achieve rapid and complete recanalisation while avoiding complications. Apart from the conventional complications of neurointerventional procedures, mechanical thrombectomy has its unique set of complications, inherent to the disease pathophysiology. We describe an unusual complication of catheter fracture and subsequent distal embolisation into the cerebral vasculature, which was noticed 24 hours after the procedure. Due to a lack of clinical consequences, we decided to manage it conservatively. The patient died within the following few days from respiratory complications unrelated to the stroke or the endovascular thrombectomy procedure. Consequently, we were able to retrieve the fractured segment and carry out histopathological analysis, which helped us to identify exactly its origin from the guide catheter. We believe that systematic reporting and database compilation of such device-related complications will aid in the design and development of neurointerventional devices in the future.

摘要

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本文引用的文献

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World Neurosurg. 2018 Aug;116:214-218. doi: 10.1016/j.wneu.2018.05.106. Epub 2018 May 23.
2
Direct Aspiration Catheter Fracture and Retrieval during Neurothrombectomy.神经血栓切除术期间直接抽吸导管断裂与取出
Interv Neurol. 2018 Apr;7(3-4):148-152. doi: 10.1159/000486245. Epub 2018 Jan 25.
3
Complications of endovascular treatment for acute ischemic stroke: Prevention and management.急性缺血性脑卒中血管内治疗的并发症:预防与处理。
Int J Stroke. 2018 Jun;13(4):348-361. doi: 10.1177/1747493017743051. Epub 2017 Nov 24.
4
Long term experience using the ADAPT technique for the treatment of acute ischemic stroke.ADAPT 技术治疗急性缺血性脑卒中的长期经验。
J Neurointerv Surg. 2017 May;9(5):437-441. doi: 10.1136/neurintsurg-2015-012211. Epub 2016 Apr 18.
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Inadvertent Stent Retriever Detachment: A Multicenter Case Series and Review of Device Experience FDA Reports.不经意的支架取栓器脱离:一项多中心病例系列研究及对FDA报告中器械使用经验的回顾
Interv Neurol. 2016 Mar;4(3-4):75-82. doi: 10.1159/000441920. Epub 2015 Nov 20.
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2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.2015年美国心脏协会/美国卒中协会对2013年急性缺血性卒中患者早期管理指南中血管内治疗部分的重点更新:美国心脏协会/美国卒中协会给医疗专业人员的指南
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