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E-273 Addressing the ‘hook-in’ problem in accero stent-assisted coil embolization: understanding cases, and solutions
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  1. M Kim,
  2. Y Jung
  1. Neurovascular surgery/Neurointervention, Daegu, Korea, Republic of

Abstract

The Accero stent employs platinum-nitinol composite wire technology with a low-profile, visible, and braided structure. The Accero stent-assisted coil embolization is crucial for treating cerebral aneurysms, but concerns about proximal end detachment have emerged. This report delves into the causes, structure, and proposed solutions for the ‘hook in’ issue during the procedure.

The report aims to provide insights into the Accero stent’s structure, analyzing a case involving a ‘hook in’ problem, and proposing systematic solutions.

In a case involving a 74-year-old woman with a bilobulated aneurysm, a ‘hook in’ situation occurred during Accero stent-assisted coil embolization, requiring careful maneuvering for successful deployment.

Structural analysis revealed a critical interaction between the transport wire (TW) wings of the crown sleeve and the stent mesh. Proper alignment of the TW within the stent is crucial for stable deployment, with misalignment issues leading to interference during TW removal, causing the ‘hook in’ problem.

To address the issue, precise positioning of the Accero stent and TW is essential. Proposed steps include verifying stent deployment, confirming central positioning of MC and TW, and carefully addressing misalignments during TW removal.

In conclusion, understanding the intricate connection between the Accero stent and TW wire is crucial for successful embolization. The report emphasizes the need for meticulous attention to device positioning and provides systematic steps to mitigate the ‘hook in’ problem, contributing valuable insights to enhance the safety and effectiveness of Accero stent-assisted coil embolization procedures.

Disclosures M. Kim: None. Y. Jung: None.

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