Retrograde trans-posterior communicating artery rescue balloon angioplasty of incompletely expanded pipeline embolization device: complication management.

Pipeline embolization device aneurysm embolization complication complication management deployment failure flow diversion device incomplete expansion rescue strategy salvage strategy vertebral artery aneurysm

Journal

British journal of neurosurgery
ISSN: 1360-046X
Titre abrégé: Br J Neurosurg
Pays: England
ID NLM: 8800054

Informations de publication

Date de publication:
Jun 2023
Historique:
medline: 19 6 2023
pubmed: 19 5 2020
entrez: 19 5 2020
Statut: ppublish

Résumé

Pipeline embolization device (PED) deployment is a technically demanding procedure. Incomplete device expansion or deployment is one intra-operative risk, especially in patients with significant vascular tortuosity. We describe the case of a 71-year female with an unruptured left vertebral artery saccular aneurysm. Tortuosity of the arteries proximal to the aneurysm complicated deployment and the proximal end of the PED failed to expand despite several maneuvers. The inadequately expanded PED caused flow limitation in the left vertebral artery and it became imperative to achieve wall apposition of the PED. We salvaged the PED from the left vertebral artery by retrograde trans-right posterior communicating artery balloon angioplasty. Our case documents the successful application of the rarely used salvage strategy - anterior-to-posterior circulation retrograde rescue balloon angioplasty of an unopened PED.

Sections du résumé

BACKGROUND UNASSIGNED
Pipeline embolization device (PED) deployment is a technically demanding procedure. Incomplete device expansion or deployment is one intra-operative risk, especially in patients with significant vascular tortuosity.
CASE DESCRIPTION UNASSIGNED
We describe the case of a 71-year female with an unruptured left vertebral artery saccular aneurysm. Tortuosity of the arteries proximal to the aneurysm complicated deployment and the proximal end of the PED failed to expand despite several maneuvers. The inadequately expanded PED caused flow limitation in the left vertebral artery and it became imperative to achieve wall apposition of the PED. We salvaged the PED from the left vertebral artery by retrograde trans-right posterior communicating artery balloon angioplasty.
CONCLUSIONS UNASSIGNED
Our case documents the successful application of the rarely used salvage strategy - anterior-to-posterior circulation retrograde rescue balloon angioplasty of an unopened PED.

Identifiants

pubmed: 32419501
doi: 10.1080/02688697.2020.1764495
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

360-363

Auteurs

Amey R Savardekar (AR)

Department of Neurosurgery, LSU-HSC, Shreveport, LA, USA.

Devi Prasad Patra (DP)

Department of Neurosurgery, LSU-HSC, Shreveport, LA, USA.

Anil Nanda (A)

Department of Neurosurgery, LSU-HSC, Shreveport, LA, USA.

Hugo Humberto Cuellar-Saenz (HH)

Department of Neurosurgery, LSU-HSC, Shreveport, LA, USA.

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