The DED seems effective and safe in the treatment of different kinds of intracranial aneurysms.

Endovascular stroke treatment is a neurointerventional emergency where the main goal is the early recanalization of the occlusion within the critical time window, as safely as possible. Although the time window and rate of complications for endovascular stroke treatment differ with anterior and posterior circulation strokes, awareness of potential periprocedural complications is important, as they affect patient morbidity and mortality. Periprocedural complications are classified as haemorrhagic complications, procedure-/device-related, puncture site complications, and late-onset events including vascular stenosis. We present the digital subtraction angiography and CT imaging findings related to these complications in a study of 56 stroke patients, as they relate to previous findings in the literature.

Spontaneous Solitaire™ stent retriever detachment is a rarely defined entity seen during stroke treatment, which can result in a disastrous clinical outcome if it cannot be solved within a critical stroke treatment time window. Two solutions to this problem are presented in the literature. The first is to leave the stent in place and apply angioplasty to the detached stent, while the second involves surgically removing the stent from the location at which it detached. Here, we present a case of inadvertent stent detachment during stroke treatment for a middle cerebral artery M1 occlusion resulting in progressive thrombosis. The detached stent was removed endovascularly by another Solitaire stent, resulting in the recanalization of the occluded middle cerebral artery.

In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although CT angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in patients with acute stroke. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography. 11 out of 72 patients had pseudo-occlusion on CTA. Of these, there were three cases of tandem occlusions accompanying highgrade ICA stenosis, five cases of Distal ICA bifurcation occlusion as a result of atrial fibrillation, two cases of cervical ICA dissection and one acute thrombosis of the stent. Consideration of the aforementioned aetiologies by interventionists is warranted, as it may change the planning of endovascular intervention and treatment of acute stroke.

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