Open AccessEfficacy and safety of a modified pigtail-shaped microguidewire during endovascular thrombectomy
Author(s) -
Fuminori Ato,
Tomotaka Ohshima,
Shigeru Miyachi,
Naoki Matsuo,
Reo Kawaguchi,
Misako Takayasu
Publication year - 2019
Publication title -
asian journal of neurosurgery
Language(s) - English
Resource type - Journals
ISSN - 1793-5482
DOI - 10.4103/ajns.ajns_28_19
Subject(s) - medicine , aneurysm , extravasation , radiology , subarachnoid hemorrhage , occlusion , angiography , cerebral angiography , surgery , immunology
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.