Tatsuta Yasuyuki, Ogino Tatsuya, Endo Hideki, Sakurai Suguru, Nakamura Hirohiko
Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido 060-8570, Japan.
Radiol Case Rep. 2023 Apr 6;18(6):2112-2115. doi: 10.1016/j.radcr.2023.02.059. eCollection 2023 Jun.
Carotid artery stenting is a treatment option for patients with significant symptomatic or asymptomatic carotid artery stenosis. Although use of an embolic protection device during carotid artery stenting can prevent distal embolization, device retrieval after stenting can be difficult. In this report, during an embolic protection device retrieval, it was not possible to advance recapture catheters through the distal flare segment of the stent because the device wire would catch on the flare or become jammed between the flare and vessel wall. Then, an extension wire was connected to the end of the device and a 5.2-Fr JB2-type balloon catheter was advanced over the wire, which was able to pass through the stent. The use of a 5.2-Fr JB2-type balloon catheter to retrieve a trapped embolic protection device is feasible and effective if standard maneuvers fail.
颈动脉支架置入术是有明显症状或无症状的严重颈动脉狭窄患者的一种治疗选择。虽然在颈动脉支架置入术中使用栓子保护装置可预防远端栓塞,但支架置入术后取出该装置可能困难。在本报告中,在取出栓子保护装置时,由于装置导丝会卡在支架远端喇叭口段或卡在喇叭口与血管壁之间而无法推进回收导管通过支架的远端喇叭口段。然后,将一根延长导丝连接到装置末端,并将一根5.2F JB2型球囊导管沿导丝推进,该导管能够通过支架。如果标准操作失败,使用5.2F JB2型球囊导管取出被困的栓子保护装置是可行且有效的。