Surgical neurology international · 2025
A case of microguidewire entrapment during mechanical thrombectomy for posterior cerebral artery occlusion.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Ishikawa Kohei, Kato Naoki, Nagayama Gota, Sano Tohru, Nakayama Yosuke, Kazami Kenta, Matsumoto Michinori, Gocho Takeshi, Ishibashi Toshihiro, Murayama Yuichi
Аннотация
BACKGROUND: As mechanical thrombectomy is commonly performed, preparation for various complications is necessary. However, few reports have described microguidewires (MGWs) becoming entrapped.
CASE DESCRIPTION: An 83-year-old man with a history of cancer in the pancreatic head developed a disturbance of consciousness and left hemiplegia. Mechanical thrombectomy was performed for occlusion of the right posterior cerebral artery. The occluded lesion was passed using an MGW with a straight tip. The MGW became impossible to move after advancing into the perforator distal to the occluding thrombus. The MGW was removed using a goose-neck snare under general anesthesia. A small amount of subarachnoid hemorrhage occurred after wire removal but did not affect the clinical course.
CONCLUSION: MGW entrapment is a rare complication in neuroendovascular therapy, particularly in mechanical thrombectomy. Removal of an entrapped MGW is associated with a risk of hemorrhagic complications. If the thrombus is hard and a J-shaped wire cannot be passed, the risk of MGW entrapment is high.
CASE DESCRIPTION: An 83-year-old man with a history of cancer in the pancreatic head developed a disturbance of consciousness and left hemiplegia. Mechanical thrombectomy was performed for occlusion of the right posterior cerebral artery. The occluded lesion was passed using an MGW with a straight tip. The MGW became impossible to move after advancing into the perforator distal to the occluding thrombus. The MGW was removed using a goose-neck snare under general anesthesia. A small amount of subarachnoid hemorrhage occurred after wire removal but did not affect the clinical course.
CONCLUSION: MGW entrapment is a rare complication in neuroendovascular therapy, particularly in mechanical thrombectomy. Removal of an entrapped MGW is associated with a risk of hemorrhagic complications. If the thrombus is hard and a J-shaped wire cannot be passed, the risk of MGW entrapment is high.