In Vivo Retrieval of a Trapped Merci Embolectomy Device

Gordhan, Ajeet; Soliman, John

doi:10.1227/01.neu.0000383748.34118.d3

Cited by 3 publications

(4 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous case reports implicate target artery vasospasm during thrombectomy as the cause of fixation and entrapment of the Merci device and unsuccessful recanalization of the occluded artery . These authors further describe improvement with local infusion of spasmolytic agents.…”

Section: Discussionmentioning

confidence: 74%

“…Thus, device fracture may not relate to the cumulative number of retrieval attempts as with other procedural complications, but is a potential risk with each individual thrombectomy attempt. Previous case reports implicate target artery vasospasm during thrombectomy as the cause of fixation and entrapment of the Merci device and unsuccessful recanalization of the occluded artery [14,15]. These authors further describe improvement with local infusion of spasmolytic agents.…”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Impact of Merci Device Fracture on Clinical Outcome of Acute Ischemic Stroke after Mechanical Thrombectomy

et al. 2012

View full text Add to dashboard Cite

SUMMARY Aims To investigate the frequency and predictors of Merci device fracture in patients with acute ischemic stroke treated with mechanical thrombectomy and its impact on clinical outcome. Methods We retrospectively analyzed patients with acute ischemic stroke treated by thrombectomy with the Merci Retriever and identified the presence of device fracture. The predictors of device fracture were assessed. We evaluated the impact of device fracture on hemorrhage and clinical outcome. Results Of 136 patients treated by thrombectomy, 6 (4.4%) experienced intraprocedural Merci device fracture. Internal carotid artery occlusion was associated with device fracture. The fractured X and L series Merci Retrievers were successfully ensnared in four patients. Patients with fractured devices had similar rates of successful revascularization with those without. In patients with fractured devices, no parenchymal hematomas were found, while hemorrhagic infarction and subarachnoid hemorrhage were found in three and two patients, respectively. Patients with fractured devices tended to be more dependent (modified Rankin Scale ≥ 3) at discharge, but had similar rates of in-hospital mortality. Conclusions Merci device fracture is relatively infrequent in patients with acute ischemic stroke treated with thrombectomy. This complication may not increase the risk of parenchymal hematoma but tends to be associated with poor outcome.

show abstract

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 83%

Impact of Merci Device Fracture on Clinical Outcome of Acute Ischemic Stroke after Mechanical Thrombectomy

et al. 2012

View full text Add to dashboard Cite

show abstract

“…[1][2][3] The reasons for entrapment include the glue used in microcatheters and the induction of vasospasms for the embolectomy device. However, the in vivo entrapment of a microwire has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Entrapment of a micro-guidewire during stenting of basilar stenosis

Wang

et al. 2013

BMJ Case Reports

View full text Add to dashboard Cite

Entrapment of a microwire related to intracranial endovascular therapy is an uncommon complication. A 64-year-old man with symptomatic basilar artery stenosis was treated with stenting. A 300 cm Synchro microwire became trapped in the P1 segment of the left posterior cerebral artery during the procedure. The decision was made to leave the microwire in place, considering that aggressive retrieval procedures could cause injury to the cerebral vasculature. The entrapped microwire was later inadvertently dislocated and removed while pulling the microwire back into the femoral artery with a looped catheter from the left femoral access. This demonstrates that, although entrapment of a microwire during endovascular therapy is a rare event, an optimal salvage technique needs to be explored further.

show abstract

“…Entrapped devices related to intracranial endovascular therapy, including microcatheters following Onyx treatment of intracranial arteriovenous malformations and the Merci embolectomy device following mechanical thrombolysis, have been described. [1][2][3] The reasons for entrapment include the glue used in microcatheters and the induction of vasospasms for the embolectomy device. However, the in vivo entrapment of a microwire has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%