Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms
Autor: | Byong-Cheol Kim, Joon Ho Song, Jun Hyong Ahn, Dong-Keun Hyun, Byung Moon Cho, Ho Kook Lee, In Bok Chang, Hyo Sub Jun |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Mechanical Thrombolysis medicine.medical_treatment Aneurysm Ruptured 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm Blood vessel prosthesis Modified Rankin Scale Occlusion medicine Humans cardiovascular diseases Infusions Intravenous Aged Retrospective Studies Thrombectomy business.industry Stent Intracranial Aneurysm General Medicine Tirofiban Thrombolysis Middle Aged medicine.disease Embolization Therapeutic Surgery Blood Vessel Prosthesis Treatment Outcome Tyrosine Female Stents Neurology (clinical) Radiology business 030217 neurology & neurosurgery medicine.drug |
Zdroj: | Journal of neurointerventional surgery. 9(3) |
ISSN: | 1759-8486 |
Popis: | ObjectiveTo examine the safety and efficacy of mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms.MethodsBetween June 2011 and June 2015, 631 consecutive patients with ruptured intracranial aneurysms underwent coil embolization at 6 hospitals. Among 53 patients who had thromboembolic complications, 15 patients harboring 15 aneurysms underwent rescue mechanical thrombectomy with a retrievable stent for the treatment of thromboembolic occlusion during the coiling of ruptured aneurysms. The patients' clinical and radiologic outcomes were retrospectively reviewed.ResultsOf the 15 aneurysms, coiling alone was used for 13 (86.7%), and stent-assisted coiling was performed for 2 (13.3%). Thromboembolic occlusion most frequently occurred distal to the aneurysm (n=10, 66.7%), followed by proximal to the aneurysm (n=3, 20%), and at the coil−parent vessel interface (n=2, 13.3%). All patients underwent mechanical thrombectomy with a retrievable stent, including 5 patients who were initially treated with an IA tirofiban infusion. Complete recanalization (Thrombolysis in Cerebral Infarction (TICI) 3) was obtained in 13 (86.7%) and partial recanalization (TICI 2b) in 2 (13.3%). Two patients who had received IA tirofiban before mechanical thrombectomy had hemorrhagic complications. At 6 months after discharge, 9 patients had a modified Rankin Scale (mRS) score of 1, 3 patients were mRS 2, 1 patient was mRS 3, 1 patient was mRS 4, and 1 patient was mRS 6.ConclusionsRescue mechanical thrombectomy using a retrievable stent can be a useful treatment for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms. |
Databáze: | OpenAIRE |
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