Efficacy and safety of a modified pigtail-shaped microguidewire during endovascular thrombectomy

Fuminori Ato; Tomotaka Ohshima; Shigeru Miyachi; Naoki Matsuo; Reo Kawaguchi; Masakazu Takayasu

doi:10.4103/ajns.AJNS_28_19

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 1040-1043
DOI: 10.4103/ajns.AJNS_28_19

Case Report

Efficacy and safety of a modified pigtail-shaped microguidewire during endovascular thrombectomy

Authors

Fuminori Ato

Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
Tomotaka Ohshima

¹Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi
Shigeru Miyachi

¹Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi
Naoki Matsuo

Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
Reo Kawaguchi

Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
Masakazu Takayasu

Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi

Abstract

A 75-year-old man presented with right-sided hemiplegia and was diagnosed with a left middle cerebral artery occlusion. He underwent endovascular thrombectomy, and a bulge was found. A modified pigtail-shaped microguidewire (MPMGW) proved useful for diagnosis because it allowed differentiation between the occluded artery and a saccular aneurysm as the etiology. When a clot was partially retrieved, a previously unidentified vessel dilatation appeared. The dilatation origin was unclear and could have resulted from either the occluded artery or an unruptured saccular aneurysm. We tried to navigate the MPMGW into the bulging area. The patient showed unusual body movement attributed to pain and the dilatation was diagnosed as an aneurysm. Subsequent 3-dimensional angiography revealed a recanalized artery and the aneurysm. With no subarachnoid hemorrhage or extravasation of the contrast medium. The hemiplegia dramatically improved. An MPMGW may be useful in acute thrombectomy where the target vessel cannot be visualized during the procedure.

Key-words:

Acute ischemic stroke - endovascular treatment - microguidewire - modified pigtail-shape - thrombectomy

Full Text

References

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