Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
"Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
Interv Neuroradiol. 2024 Aug;30(4):592-596. doi: 10.1177/15910199221118709. Epub 2022 Aug 4.
Intra-procedural intrasaccular device migration is an uncommon complication of endovascular treatment of wide-neck aneurysms. We report the case of a 52-years old Caucasian male who presented with a 3 × 3 mm posterior facing top of the basilar aneurysm in which treatment with WEB-SL (Woven EndoBridge-single layer) device was tempted. Inadvertent WEB migration in the right posterior cerebral artery occurred after detachment. Two retrieval attempts were performed using a combined technique with two different stent-retrievers and a 5-Fr distal access catheter. Upon WEBectomy attempt, the device rolled over the stents, and the passages were unsuccessful. The device was successfully removed using a microSnare, catching and retrieving it inside the 5-Fr distal access catheter. Micro-Snare is an effective bail-out technique to recover migrated intrasaccular WEB devices in cerebral arteries.
术中囊内装置迁移是宽颈动脉瘤血管内治疗的一种罕见并发症。我们报告了一例 52 岁的高加索男性患者，他患有 3×3 毫米的后颅底基底动脉顶端动脉瘤，尝试使用 WEB-SL（编织式 EndoBridge-单层）装置进行治疗。在分离后，WEB 装置意外迁移到右侧大脑后动脉。使用两种不同的支架取栓器和 5Fr 远端通路导管的联合技术进行了两次取回尝试。在 WEB 切除术尝试中，装置在支架上滚动，通道不成功。使用微圈套器成功取出装置，将其捕获并收回到 5Fr 远端通路导管内。微圈套器是一种有效的救援技术，可以在脑动脉中取回迁移的囊内 WEB 装置。
