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Balloon-assisted tracking technique to overcome intracranial stenosis during thrombectomy for stroke.

Research paper by Jan-Karl JK Burkhardt, Maksim M Shapiro, Omar O Tanweer, Miguel M Litao, Breehan B Chancellor, Eytan E Raz, Howard A HA Riina, Peter Kim PK Nelson

Indexed on: 24 Dec '18Published on: 24 Dec '18Published in: Journal of neurointerventional surgery



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. © BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.