Introduction With the advancement of mechanical thrombectomy techniques for the treatment of stroke, complications related to this type of treatment have also increased. Although the most common adverse events reported are: reperfusion hemorrhage, subarachnoid hemorrhage, clot embolization and vasospasm, a less commonly reported complication is breakage and retention of the thrombectomy devices. This type of complication not only results in failure of the mechanical thrombectomy procedure but, in addition, leave a thrombogenic foreign object inside the cerebral artery, which can potentially lead to clot propagation and stroke progression. Very few articles concerning this particular type of complications are reported in the literature.
Aim of Study We report a very rare case in which during a mechanical thrombectomy the tip of the aspiration catheter (Red 62) broke off intracranially and is subsequently recovered.
Methods The 68-year-old female patient, with NIHSS 16, presented a clot in right MCA M1. After one passage, using a combined technique, the aspiration catheter was damaged with persistence of its radiopaque tip within the MCA.
Results We decided to use a double stent-retriever technique (‘’Y-stentretriever’’) to catch the aspiration catheter’s tip. After only one maneuver with this technique we manage to catch the tip and pull it out. The final results, after 30 minutes, was TICI2c.
Conclusion Breakage and retention of the thrombectomy devices represents a very rare cause of complications during mechanical thrombectomy but nevertheless possible. We have reported this case, with its related treatment, in order to help the management of this type of complication.
Disclosure of Interest Dr. D.G. Romano consultant and proctor for BALT Italy, Microvention Europe, Penumbra Inc.
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