Surgical management for retained distal embolic protection device and fractured guidewire after carotid artery stenting.

Autor: Li T; Stroke Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Zha Y; University of California Irvine, School of Medicine, Irvine, CA, USA Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Bo L; Stroke Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Wirthlin DJ; Vascular Surgery and Wound Care Center, LDS Hospital, Salt Lake City, UT, USA., Zhang Q; Stroke Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China dr.qinyi@163.com.
Jazyk: angličtina
Zdroj: Journal of surgical case reports [J Surg Case Rep] 2016 Jun 17; Vol. 2016 (6). Date of Electronic Publication: 2016 Jun 17.
DOI: 10.1093/jscr/rjw105
Abstrakt: Entrapment and fracture of carotid angioplasty and stenting hardware is a rare complication of percutaneous stenting procedures. We describe a case of a retained distal filter embolic protection device and guidewire in a 57-year-old male in Beijing, China. After unsuccessful attempts at removal via interventional methods, a second stent was deployed to secure the original hardware in situ, and the patient was discharged. He later experienced guidewire fragmentation in the carotid artery and aortic arch, with subsequent thrombus formation. We report partial removal of the guidewire and stent via carotid artery cutdown and open thoracotomy without complication. When efforts to retrieve stenting hardware are unsuccessful, it is never a suitable choice to leave them within the artery. We advocate for early surgical management of retained materials after unsuccessful carotid artery stenting. Furthermore, improved quality monitoring and assurance programs are needed to prevent such complications in the future.
(Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.)
Databáze: MEDLINE
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