Introduction: The safety and efficacy of mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms has rarely been reported.
Methods: Between June 2011 and June 2015, 631 consecutive patients with ruptured intracranial aneurysms underwent coil embolization at 5 hospitals. Among 53 patients who suffered from thromboembolic complications, 15 patients harboring 15 aneurysms underwent rescue mechanical thrombectomy with retrievable stent for the treatment of thromboembolic occlusion during the coiling of ruptured aneurysms. The patients’ clinical and radiologic outcomes were retrospectively reviewed.
Results: Of the 15 aneurysms, coiling alone was used for 13 (86.7%), and stent-assisted coiling was performed for 2 (13.3%). Thromboembolic occlusion most frequently occurred distal to the aneurysm (n=10, 66.7%), followed by proximal to the aneurysm (n=3, 20%), and coil-parent vessel interface (n = 2, 13.3%). All patients underwent mechanical thrombectomy with retrievable stent, including 5 patients who were initially treated with intra-arterial tirofiban infusion. Complete recanalization (TICI 3) was obtained in 13 (86.7%) and partial recanalization (TICI 2b) in 2 (13.3%). Two patients who had received intra-arterial tirofiban infusion before mechanical thrombectomy suffered from hemorrhagic complications. At 6 months after discharge, 9 patients were mRS 1, 3 patients were mRS 2, 1 patient was mRS 3, 1 patient was mRS 4, and 1 patient was mRS 6.
Conclusions: Rescue mechanical thrombectomy using a retrievable stent can be a useful treatment option for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms.
Patient Care: Rescue mechanical thrombectomy using a retrievable stent can be a useful treatment option with a high rate of recanalization, and further improve functional outcome of patients.
Learning Objectives: .Identify an effective treatment for thromboembolic occlusion during coil embolization of ruptured intracranial aneurysms