Ok Taedong, Yoon Pyeong Ho, Seo Kwon-Duk
Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Neurointervention. 2024 Nov;19(3):180-184. doi: 10.5469/neuroint.2024.00409. Epub 2024 Oct 21.
Mechanical thrombectomy using a stent retriever is a widely-used technique for recanalizing occluded cerebral arteries in acute ischemic stroke. Although rare, inadvertent stent detachment has primarily been reported with earlier stent retriever designs. We present 2 cases of inadvertent stent detachment with the pRESET stent. In the first case, an elderly patient presented with right middle cerebral artery occlusion and experienced stent detachment during the second retrieval. Despite this, successful recanalization was achieved through balloon angioplasty. In the second case, an elderly patient experienced stent detachment after the third retrieval, and recanalization of the M1 segment was unsuccessful due to the inability to pass the microcatheter. The first patient had a modified Rankin scale (mRS) score of 3, while the second had a poor prognosis with an mRS score of 5. These cases highlight that inadvertent stent detachment can impact outcomes, and balloon angioplasty may serve as a useful salvage therapy.
使用支架取栓器进行机械取栓是急性缺血性卒中时使闭塞脑动脉再通的一种广泛应用的技术。尽管罕见,但无意的支架脱离主要见于早期的支架取栓器设计。我们报告2例使用pRESET支架时发生无意支架脱离的病例。第一例,一名老年患者出现右侧大脑中动脉闭塞,在第二次取栓时发生支架脱离。尽管如此,通过球囊血管成形术成功实现了再通。第二例,一名老年患者在第三次取栓后发生支架脱离,由于无法通过微导管,M1段再通未成功。第一名患者改良Rankin量表(mRS)评分为3分,而第二名患者预后较差,mRS评分为5分。这些病例突出表明,无意的支架脱离可能影响预后,球囊血管成形术可能是一种有用的挽救治疗方法。