我们描述了一种在线圈栓塞过程中突出的线圈的情况,该情况使用独特的技术来调整圈套器位置。该患者是一名44岁的女性,患有未破裂的右颈内动脉(ICA)动脉瘤,其生长时间超过1.5年。进行线圈栓塞。最终线圈分离和微导管移除后,最终线圈突出到ICA中并漂浮。尝试使用圈套进行线圈检索,但圈套器不能放置在线圈尾部和线圈回收不能实现。使用以下技术来调整圈套器位置。首先,将一根微导丝和一根微导管作为圈套器的单轨引导器引导到大脑中动脉的M2和M1段,分别。接下来,圈套器在微导管上前进。在ICA的C2段周围,微导管和圈套器作为一个单元进行操作。因此,圈套器可以放置在突出的线圈尾部周围,并成功取回线圈。当使用圈套时,该技术可以广泛地适用于各种情况。
Although snares are useful devices to retrieve an intravascular foreign body, the control of snares is often difficult. We present a safe and effective technique to adjust snare position in the tortuous vessel for coil retrieval during endovascular coil embolization.
We describe a
case of a protruding coil during coil embolization that was successfully retrieved using a unique technique to adjust snare position and discuss additional intraprocedural bailout strategies for retrieving a coil during endovascular coil embolization.
The patient was a 44-year-old female with unruptured right internal carotid artery (ICA) aneurysm that had grown over a 1.5-year period. Coil embolization was performed. After detachment of final coil and microcatheter removal, the final coil protruded into the ICA and floated. Coil retrieval using a
snare was attempted, but the
snare could not be placed around the coil tail and coil retrieval could not be achieved. The following technique was used to allow adjustment of
snare position. First, a microguidewire and a microcatheter were guided into the M2 and M1 segment of the middle cerebral artery as monorail guides of the snare, respectively. Next, the
snare was advanced over the microcatheter. Around C2 segment of the ICA, the microcatheter and the snare were manipulated as a unit. Thus, the snare could be placed around the protruding coil tail and the coil was retrieved successfully.
This technique may be widely adapted for various situations when using a
snare.