Robichaux Jared M, Lawhon Sarah E, Girolamo Taylor W, Owens Kapland Q, Ponce Mejia Lucido L
Departments of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Departments of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
J Neurosurg Case Lessons. 2024 Nov 18;8(21). doi: 10.3171/CASE24376.
With the growing utilization of general endovascular techniques, iatrogenic endovascular foreign bodies have become more prevalent. Contact aspiration has proven to be a valuable technique in treating ischemic strokes by removing the intraluminal thrombus causing cerebral perfusion deficits and neurological symptoms. The authors present a case of the removal of a foreign body from the vasculature via contact aspiration, which had embolized in a delayed fashion after aortic valve replacement.
A 54-year-old male developed intermittent left-sided weakness 8 days after aortic valve replacement. A head computed tomography scan showed a metallic foreign body within the origin of the M2 superior division of the middle cerebral artery suspected to be a migrated Cor-Knot fastener. During angiography, the foreign body was repositioned and removed via contact aspiration. Postprocedurally, magnetic resonance imaging scans showed a small area of diffusion restriction in the right basal ganglia. The patient was neurologically intact and was discharged on postprocedure day 2 without further neurological sequelae.
Contact aspiration is a safe and effective technique to remove foreign bodies from the intracranial circulation; however, it requires a quality interface between the aspiration catheter and the foreign body throughout the aspiration process. https://thejns.org/doi/10.3171/CASE24376.
随着一般血管内技术应用的增加，医源性血管内异物变得更加常见。接触抽吸已被证明是一种通过清除导致脑灌注不足和神经症状的腔内血栓来治疗缺血性中风的有价值技术。作者介绍了一例通过接触抽吸从血管系统中取出异物的病例，该异物在主动脉瓣置换术后延迟栓塞。
一名54岁男性在主动脉瓣置换术后8天出现间歇性左侧肢体无力。头部计算机断层扫描显示大脑中动脉M2上部分支起始处有一个金属异物，怀疑是移位的Cor-Knot紧固件。在血管造影过程中，通过接触抽吸将异物重新定位并取出。术后，磁共振成像扫描显示右侧基底节有一小片弥散受限区域。患者神经功能完好，术后第2天出院，无进一步神经后遗症。
接触抽吸是从颅内循环中取出异物的一种安全有效的技术；然而，在整个抽吸过程中，抽吸导管和异物之间需要良好的界面。https://thejns.org/doi/10.3171/CASE24376。
