تقرير
Endovascular Rescue Strategies for Nonopening of Pipeline Device: Report of Two Cases.
| العنوان: | Endovascular Rescue Strategies for Nonopening of Pipeline Device: Report of Two Cases. |
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| المؤلفون: | Mahajan A; Department of Neurosciences, Medanta-The Medicity, Gurgaon, Haryana, India., Banga V; Department of Neurosciences, Medanta-The Medicity, Gurgaon, Haryana, India., Chatterjee A; Department of Neurosciences, Medanta-The Medicity, Gurgaon, Haryana, India., Goel G; Department of Neurosciences, Medanta-The Medicity, Gurgaon, Haryana, India. |
| المصدر: | Asian journal of neurosurgery [Asian J Neurosurg] 2019 Nov 25; Vol. 14 (4), pp. 1240-1244. Date of Electronic Publication: 2019 Nov 25 (Print Publication: 2019). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme Medical and Scientific Publishers Pvt. Ltd Country of Publication: India NLM ID: 101564712 Publication Model: eCollection Cited Medium: Print ISSN: 1793-5482 (Print) NLM ISO Abbreviation: Asian J Neurosurg Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : UP, India : Thieme Medical and Scientific Publishers Pvt. Ltd. Original Publication: Mumbai : Medknow Publications and Media Pvt. Ltd. |
| مستخلص: | We report two cases of rescue strategies for nonopening of Pipeline flow-diverter device for the treatment of intracranial aneurysm. The first patient, a 65-year-old female, presented with complaints of headache for 3 months and was found to have giant supraclinoid internal carotid artery (ICA) (ophthalmic segment) aneurysm. We planned endovascular partial coiling and flow-diverter placement for the treatment of ICA aneurysm. During the progressive deployment of PED, there was nonopening of Pipeline embolization device (PED) at its proximal end. We tried multiple attempts to navigate Marksman microcatheter over the PED delivery microwire and Echelon microcatheter over the Traxcess microwire across the pinched site, but we were not able to achieve success. After that, we tried opposite transcranial approach across prominent anterior communicating artery with the Synchro and Transcend microguidewire which finally resulted in the opening of the device; however, there was acute extravasation of dye on check angiogram. Thus, our technical success turned into disaster. The second patient, a 55-year-old female, presented with complaint of seizures for 3 months due to mass effect of cavernous sinus aneurysm. Pipeline Flex flow-diverter placement was done across the aneurysm neck. During the progressive deployment of device, there was nonopening of the mid and proximal segment of Pipeline Flex which was successfully managed by intra-Navien deployment of device followed by simultaneous push of Marksman microcatheter and pull of Navien catheter. In our case series, two rescue strategies were applied to successfully open the proximal constricted portion of Pipeline Flex; however, technical success in one case resulted in unmanageable disasters. Thus, transcranial rescue strategy for opening the constricted Pipeline Flex device should be cautiously used in our endovascular practice. Competing Interests: There are no conflicts of interest. (Copyright: © 2019 Asian Journal of Neurosurgery.) |
| References: | Radiology. 2013 Jun;267(3):858-68. (PMID: 23418004) BMJ Case Rep. 2014 Jan 27;2014:null. (PMID: 24469910) J Neurointerv Surg. 2015 Sep;7(9):628-33. (PMID: 24996435) Neurotherapeutics. 2016 Jul;13(3):582-9. (PMID: 27160270) J Neurointerv Surg. 2016 Aug;8(8):840-6. (PMID: 26101269) J Cerebrovasc Endovasc Neurosurg. 2013 Sep;15(3):241-5. (PMID: 24167807) J Neurointerv Surg. 2015 Dec;7(12):920-5. (PMID: 25280568) |
| فهرسة مساهمة: | Keywords: Aneurysm; Pipeline Flex embolization device; Pipeline device; flow diverter; internal carotid artery; intra-Navien deployment |
| تواريخ الأحداث: | Date Created: 20200107 Latest Revision: 20201001 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC6896616 |
| DOI: | 10.4103/ajns.AJNS_191_19 |
| PMID: | 31903371 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1793-5482 |
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| DOI: | 10.4103/ajns.AJNS_191_19 |