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Preventing vessel perforations in endovascular thrombectomy: feasibility and safety of passing the clot with a microcatheter without microwire: the wireless microcatheter technique
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  • Published on:
    Multiple Factors Related to Vessel Perforations in Endovascular Thrombectomy
    • Long Chen, Interventional Radiologist The First Affiliated Hospital of Soochow University

    Congratulations to Annika Keuler et al¹ on their experience with the wireless microcatheter technique preventing vessel perforations in endovascular thrombectomy. Based on their results, the authors conclude that in most cases of mechanical recanalization, the clot can be passed more safely with a wireless microcatheter. In our daily work, we also find the wireless microcatheter technique seems to reduce subarachnoid hyperdensity resulting from vessel perforations. However it seems difficult to confirm this correlation; the details of which will be discussed as follows. After reading and analyzing the article carefully, we have some opinions about the study which we would like to communicate with the authors because the conclusions of the paper directly relate to our clinical experience.
    In the article, two radiological manifestations are defined as vessel perforations——contrast extravasation during angiography and angiographically occult ipsilateral circumscribed subarachnoid contrast extravasation which is identified by post-interventional CT scans. As confirmed by previous studies2-3, we agree with the authors on using immediate post-interventional CT examination to identify the subarachnoid hyperdensity due to intraoperative contrast extravasation. Based on their results, post-thrombectomy subarachnoid hyperdensity was observed on CT scans in 22 patients, in 18 of whom, the clot was passed using a microwire, and in the other four, using a wireless microcathete...

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    Conflict of Interest:
    None declared.