Breakage and Retrieval of an Aspiration Catheter Coil with a Stent Retriever During Mechanical Thrombectomy.

Abstract

BACKGROUND:

Some mechanical thrombectomy techniques for acute ischemic stroke use a combination of an aspiration catheter and stent retriever. We experienced a rare case of aspiration catheter coil breakage and subsequent retrieval using a stent retriever.

CASE DESCRIPTION:

A 79-year-old man suddenly developed somnolence, global aphasia, and right hemiplegia. Magnetic resonance imaging revealed acute infarction of the left frontal lobe and occlusion of the left common carotid artery. Thus, using an aspiration catheter and a stent retriever, mechanical thrombectomy was performed. The stent retriever was deployed from the middle cerebral artery to the internal carotid artery and retracted into the aspiration catheter placed in the internal carotid artery proximal to the thrombus. The catheter was bent during retraction of the stent retriever. After thrombus aspiration, the internal carotid and anterior and middle cerebral arteries were successfully reperfused; however, the stent retriever captured a broken section of the winding coil of the aspiration catheter. We suspected that an X-ray marker on the stent retriever broke the winding coil at the bent segment of the aspiration catheter and the stent captured the broken coil.

CONCLUSIONS:

The combined use of an aspiration catheter and a stent retriever may cause unexpected device breakage, especially when the catheter is bent.

• Authors: Ryotaro Otsuka, Hiroyuki Ikeda, Yoshitaka Tsujimoto, Takeshi Kawauchi, Sadaharu Torikoshi, Noritaka Sano, Makoto Hayase, Hiroki Toda
• Journal: World neurosurgery (World Neurosurg) Vol. 130 Pg. 54-58 (Oct 2019) ISSN: 1878-8769 [Electronic] United States
• PMID: 31265926 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Aged
• Catheters (adverse effects)
• Cerebral Arteries (diagnostic imaging, surgery)
• Device Removal (methods)
• Humans
• Male
• Prosthesis Failure (adverse effects)
• Self Expandable Metallic Stents (adverse effects)
• Thrombectomy (adverse effects, instrumentation)