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Clinical Neurology
Case report
Republished: Intracranial pellet embolization: an endovascular endeavor
  1. Ameer E Hassan1,2,
  2. Rani Ramsey Rabah1,
  3. Wondwossen Tekle1,2
  1. 1 Clinical Research Department, Valley Baptist Medical Center - Harlingen, Harlingen, Texas, USA
  2. 2 Department of Neurology, UTRGV School of Medicine, Edinburg, Texas, USA
  1. Correspondence to Dr Ameer E Hassan; ameerehassan{at}gmail.com

Abstract

A 44-year-old man was referred to the neurointerventionalist 6 hours after sustaining a shotgun wound to the left chest, shoulder, and neck from 4 feet away. Physical examination of the chest showed a 5 cm × 5 cm gunshot entry wound on the anterior-superior aspect of the chest involving the supraclavicular and infraclavicular region, with multiple gunshot pellet entry sites riddled in the surrounding vicinity. The patient was taken for a CT scan of the brain without contrast and CT angiography, which showed no sign of stroke or intracranial hemorrhage but revealed a single 'buckshot' pellet embolizing the basilar artery tip, occluding the origin of the left posterior cerebral artery. Using A Direct Aspiration First Pass Technique (ADAPT), the neurointerventinalist was able to endovascularly remove the embolized pellet and the patient was discharged 8 days later with no focal neurological deficit.

  • embolic
  • catheter
  • CT angiography
  • thrombectomy
  • technique

https://doi.org/10.1136/neurintsurg-2019-015301.rep

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    Footnotes

    • Republishing Republished with permission from BMJ Case Reports. Published 31 December 2019; doi:10.1136/bcr-2019-015301

    • Contributors All three authors of this case report contributed to its completion. One neurointerventionalist performed the procedure, and the remaining two authors helped write and edit the case report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.