Balloon-assisted tracking technique to overcome intracranial stenosis during thrombectomy for stroke. Issue 1 (10th December 2018)

• Record Type: Journal Article
• Authors: Burkhardt, Jan-Karl; Shapiro, Maksim; Tanweer, Omar; Litao, Miguel; Chancellor, Breehan; Raz, Eytan; Riina, Howard A; Nelson, Peter Kim
• Is Part Of: BMJ case reports. Volume 11:Issue 1(2018)
• Publication Date: 2018-12-10
• Subjects: balloon -- stroke -- thrombectomy -- stenosis; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-014275
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Anatomical vessel obstacles such as an intracranial stenosis in stroke are challenging and may lead to delayed clot access for thrombectomy. We describe a simple and effective technique to overcome the step-off between the intermediate catheter and an intracranial vessel stenosis during thrombectomy. The patient presented with acute embolic left middle cerebral artery occlusion and a favorable penumbral pattern. Clot access was made challenging by focal stenosis in the ipsilateral cavernous segment. The balloon-assisted tracking technique was effective in traversing the step-off to enable TICI 3 aspiration thrombectomy. This simple and effective technique should be kept in mind during stroke procedures where a proximal stenotic obstacle complicates access to the site of occlusion.