Refinement of a Thrombectomy Technique to Treat Acute Ischemic Stroke: Technical Note on Microcatheter Advance during Retrieving Self-Expandable Stent

Abstract

The Solitaire AB (ev3, Irvine, CA, USA) is a self-expanding, fully retrievable, nitinol stent. It was originally designed for vessel reconstruction during coil embolization of intracranial aneurysms (1). Similar to other intracranial self-expanding stents that are used for acute ischemic stroke, the Solitaire stent was introduced into the stroke intervention to restore immediate antegrade flow (2-5). Owing to the closed stent design and the structure attached to the nitinol pushwire, resheathing allows recapture even after full deployment, and thrombectomy became possible by pulling the unfolded stent back. However, withdrawing the stent in contact with endothelial surface may cause vessel trauma and stent detachment may occur inadvertently (5). Herein, we report 2 interesting cases in which the thrombus was captured safely by advancing the microcatheter along the deployed stent in the course of attempting to minimize thrombectomy-related adverse events. Case Report