A case of microguidewire entrapment during mechanical thrombectomy for posterior cerebral artery occlusion.

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.