Drakopoulou Maria, Giannopoulou Athanasia, Zampakis Petros, Messinis Lambros, Theofanopoulos Andreas, Constantoyannis Constantine, Panagiotopoulos Vasileios Evangelos
Department of Neurosurgery, University Hospital of Patras, Patras, Greece.
Department of Neuroendovascular Surgery and Interventional Neuroradiology, University Hospital of Patras, Patras, Greece.
Brain Circ. 2022 Jun 30;8(2):112-116. doi: 10.4103/bc.bc_5_22. eCollection 2022 Apr-Jun.
The aneurysm coiling process presents a risk of thromboembolic complications, mostly in patients with ruptured aneurysms, given the fact that they cannot receive antiplatelet therapy. Management strategies include medical anticoagulation or antiplatelet therapy, intra-arterial thrombolysis, and mechanical thrombectomy using direct aspiration first-pass technique or stent retrievers. We report our own experience of using an Excelsior SL-10 Microcatheter (Stryker, Fremont, California, USA) with an internal diameter of 0.0165", originally designed for coil delivery, for contact aspiration of a thrombotic occlusion of a distal anterior cerebral artery during coiling of a broad-based trilobar anterior communicating artery aneurysm. The clot was removed under continuous manual aspiration, and complete recanalization has been accomplished. Mechanical thrombectomy through microcatheter aspiration may be a safe and feasible treatment option for acute distal artery occlusions, especially in the case of tortuous distal vessels during embolization of cerebral aneurysms.
动脉瘤栓塞过程存在血栓栓塞并发症的风险，对于破裂动脉瘤患者尤为如此，因为他们无法接受抗血小板治疗。治疗策略包括药物抗凝或抗血小板治疗、动脉内溶栓以及使用直接抽吸首次通过技术或支架取栓器进行机械取栓。我们报告了我们自己使用内径为0.0165英寸的Excelsior SL - 10微导管（史赛克公司，美国加利福尼亚州弗里蒙特）的经验，该微导管最初设计用于输送弹簧圈，在宽基底三叶形前交通动脉瘤栓塞过程中用于接触抽吸大脑前动脉远端的血栓性闭塞。在持续手动抽吸下清除了血栓，并实现了完全再通。通过微导管抽吸进行机械取栓对于急性远端动脉闭塞可能是一种安全可行的治疗选择，尤其是在脑动脉瘤栓塞过程中远端血管迂曲的情况下。
