Journal of Korean Society of Geriatric Neurosurgery 2019;15(2):113-116.
Published online September 30, 2019.
Removal of Unwanted Detached Solitaire FR by using New Solitaire FR-“Distal Capture And Pull” Technique: A Case Report
Bo-Seok Kim, Jong-Hyeon Mun, Hyun-Jean Jeong, Jun-Seob Lim
Department of Neurosurgery, Kwangju Christian Hospital, Gwangju, Korea
When performing intra-arterial mechanical thrombectomy using Solitaire retriever stent in patients with acute ischemic stroke, a high recanalization rate and good clinical outcome are expected. However, there is also a risk of unwanted detachment when using Solitaire retriever stent, which may cause poor outcome and higher mortality. For the rescue, double stenting, balloon angioplasty and surgical superficial temporal artery-middle cerebral artery(STA-MCA) bypass can be performed. Also, Snare over stent-retriever(SOS) technique, ‘deploy and engage’ technique and ‘loop and snare’ technique can be used to remove the unwanted detached stent. We had an actual case of unwanted detachment in intra-arterial thrombectomy using Solitaire retriever stent and with ‘distal capture and pull’ technique, newly suggested method other than the techniques mentioned above, the unwanted detached stent could be removed. The ‘distal capture and pull’ technique is a method of deploying Solitaire retriever stent to the distal site of unwanted detached stent, making the two stent tangle each other and removing them by pulling out. Despite the expected risk, it can be attempted as a method to remove the unwanted detached stents.
Key Words: Stroke, Solitaire FR device, Mechanical thrombectomy, Detachment
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