Endovascular retrieval of bullet fragment from the basilar artery terminus. (22nd April 2022)

• Record Type: Journal Article
• Authors: Ahmed, Syed Uzair; Kelly, Michael E; Peeling, Lissa
• Is Part Of: Journal of neurointerventional surgery. Volume 14:Number 10(2022)
• Page Start: 1042
• Page End: 1044
• Publication Date: 2022-04-22
• Subjects: Stroke -- Embolic -- Thrombectomy -- Stent -- Technique; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-018751
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : A pediatric patient presented after a gunshot injury to the right shoulder and thorax region, with injuries requiring a thoracotomy, tracheal repair, axillary artery repair, and external fixation of the humerus. A CT scan of the brain showed a metal fragment in the interpeduncular cistern. CT angiography confirmed a pellet occluding the basilar apex. Successful endovascular retrieval resulted in mobilizing the pellet from the basilar apex to the left vertebral artery proximal to the posterior inferior cerebellar artery. This vertebral artery was then sacrificed proximally to prevent re-embolization. We present our technique and discuss endovascular options for management of intracranial arterial embolization of bullet fragments.