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Primary Angiitis of Central Nervous System related intracranial aneurysm with spontaneous occlusion after immunomodulatory treatment. 原发性中枢神经系统血管炎相关颅内动脉瘤在接受免疫调节治疗后自发闭塞。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-31 DOI: 10.7461/jcen.2024.E2023.04.010
Seby John, Muhammad Khan, Praveen Kesav, Divya Raj, Syed Irteza Hussain
{"title":"Primary Angiitis of Central Nervous System related intracranial aneurysm with spontaneous occlusion after immunomodulatory treatment.","authors":"Seby John, Muhammad Khan, Praveen Kesav, Divya Raj, Syed Irteza Hussain","doi":"10.7461/jcen.2024.E2023.04.010","DOIUrl":"10.7461/jcen.2024.E2023.04.010","url":null,"abstract":"<p><p>Primary Angiitis of the Central Nervous System (PACNS) is an uncommon disease with kaleidoscopic clinical manifestations. Ischemic strokes are commoner than their hemorrhagic counterpart. Intracranial pseudoaneurysms are rarely reported in PACNS cohorts. We hereby describe the case of a 39-year-old female, who presented for evaluation of acute onset of left middle cerebral artery (MCA) ischemic stroke, with cerebral angiogram showing multifocal stenosis and irregularities in intracranial blood vessels with an aneurysm arising from the lenticulostriate branch of the left MCA M1 segment. A diagnosis of probable PACNS was made and patient initiated on immunomodulatory treatment with corticosteroids. 12 weeks follow up neuroimaging studies revealed resolution of the previously described intracranial aneurysm, thereby postulating the possibility of a pseudoaneurysm related to the underlying angiitis.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"324-330"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing suction force in mechanical thrombectomy: Priming the aspiration tubing with air versus saline. 优化机械血栓切除术的抽吸力：用空气和生理盐水为抽吸管道填料。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-02-27 DOI: 10.7461/jcen.2024.E2023.09.003
Arvin R Wali, Ryan W Sindewald, Michael G Brandel, Javier Bravo, Jeffrey A Steinberg, J Scott Pannell, Alexander A Khalessi, David R Santiago-Dieppa
{"title":"Optimizing suction force in mechanical thrombectomy: Priming the aspiration tubing with air versus saline.","authors":"Arvin R Wali, Ryan W Sindewald, Michael G Brandel, Javier Bravo, Jeffrey A Steinberg, J Scott Pannell, Alexander A Khalessi, David R Santiago-Dieppa","doi":"10.7461/jcen.2024.E2023.09.003","DOIUrl":"10.7461/jcen.2024.E2023.09.003","url":null,"abstract":"<p><strong>Objective: </strong>We sought to investigate how priming the tube between air versus air mixed with saline ex vivo influenced suction force. We examined how priming the tube influenced peak suction force and time to achieve peak suction force between both modalities.</p><p><strong>Methods: </strong>Using a Dwyer Instruments (Dwyer Instruments Inc., Michigan City, IN, USA), INC Digitial Pressure Gauge, we were able to connect a .072 inch aspiration catheter to a rotating hemostatic valve and to aspiration tubing. We recorded suction force measured in negative inches of Mercury (inHg) over 10 iterations between having the aspiration tube primed with air alone versus air mixed with saline. A test was used to compare results between both modalities.</p><p><strong>Results: </strong>Priming the tube with air alone compared to air mixed with saline was found to have an increased average max suction force (-28.60 versus -28.20 in HG, p<0.01). We also identified a logarithmic curve of suction force across time in which time to maximal suction force was more prompt with air compared with air mixed with saline (13.8 seconds versus 21.60 seconds, p<0.01).</p><p><strong>Conclusions: </strong>Priming the tube with air compared to air mixed with saline suggests that not only is increased maximal suction force achieved, but also the time required to achieve maximal suction force is less. This data suggests against priming the aspiration tubing with saline and suggests that the first pass aspiration primed with air may have the greatest suction force.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"260-264"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contributing factors of spontaneous intracerebral hemorrhage development in young adults. 青壮年自发性脑内出血发病的诱因。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-06-20 DOI: 10.7461/jcen.2024.E2023.11.001
Ju-Sung Jang, Yong-Sook Park
{"title":"Contributing factors of spontaneous intracerebral hemorrhage development in young adults.","authors":"Ju-Sung Jang, Yong-Sook Park","doi":"10.7461/jcen.2024.E2023.11.001","DOIUrl":"10.7461/jcen.2024.E2023.11.001","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of spontaneous intracerebral hemorrhage (ICH) in young people is relatively low; however, it leads to devastating lifelong neurologic deficits. We focused on spontaneous ICH occurring in young adults between 30 and 50 years of age.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of 139 patients, aged 30-50 years, diagnosed with spontaneous ICH between 2011 and 2021. Cases of ICH attributable to discernible causative lesions were excluded. Demographic data, laboratory results, image findings, and clinical outcome were analyzed.</p><p><strong>Results: </strong>After exclusions, 73 patients were included in this study. Common characteristics among the study patients included male sex (83.6%), high body mass index (>25 kg/m2, 45.8%), smoking history (47.2%), heavy alcohol consumption (30.6%), previously diagnosed hypertension (41.1%), high serum triglyceride level (>150 mg/dL, 33.3%), and microbleeds or white matter changes observed on magnetic resonance images (51.3%). In the multivariate analysis, previously diagnosed hypertension was the sole significant risk factor for cerebral small vessel (OR 7.769, P=0.031). Age, brain stem location, Glasgow Coma Scale score at admission, and hematoma volume were associated with poor outcomes.</p><p><strong>Conclusions: </strong>Hypertension, obesity, smoking, and cerebral small vessel disease were important factors associated with non-lesional spontaneous intracerebral hemorrhage in young patients. Radiologic changes corresponding to cerebral small vessel disease appeared in young patients (in their 30s) and they were associated with hypertension.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"274-283"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovascular treatment of intracranial aneurysms: Past and present. 颅内动脉瘤的血管内治疗：过去与现在。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-19 DOI: 10.7461/jcen.2024.E2023.09.005
Dongming Liang
{"title":"Endovascular treatment of intracranial aneurysms: Past and present.","authors":"Dongming Liang","doi":"10.7461/jcen.2024.E2023.09.005","DOIUrl":"10.7461/jcen.2024.E2023.09.005","url":null,"abstract":"<p><p>Intracranial aneurysm is common in stroke and, once rupturing, will cause disaster to patients. Nowadays, endovascular treatment has become a routine to reduce the risk of intracranial aneurysms rupture. Successive endovascular methods, like balloon-assisted coiling, stent-assisted coiling, and flow diversion, have become new choices for doctors. More and more doctors have been entering this field. Understanding the current general situation is crucial for more medical workers to learn the endovascular treatment of intracranial aneurysms. In the past, many devices and ideas about the treatment of intracranial aneurysms appeared. Although developing unceasingly, endovascular treatment still has some deficiencies to overcome. The advantages and drawbacks of current endovascular methods are discussed.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"249-259"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative embolization and en bloc resection of a metastatic pheochromocytoma of the cervical spine. 颈椎转移性嗜铬细胞瘤的术前栓塞和整体切除术。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-06-20 DOI: 10.7461/jcen.2024.E2023.04.005
Aman Singh, Gabrielle Santangelo, Nathaniel Ellens, Gurkirat Kohli, Robert Pranaat, Matthew T Bender
{"title":"Preoperative embolization and en bloc resection of a metastatic pheochromocytoma of the cervical spine.","authors":"Aman Singh, Gabrielle Santangelo, Nathaniel Ellens, Gurkirat Kohli, Robert Pranaat, Matthew T Bender","doi":"10.7461/jcen.2024.E2023.04.005","DOIUrl":"10.7461/jcen.2024.E2023.04.005","url":null,"abstract":"<p><p>This is a unique case of metastatic pheochromocytoma of the cervical spine treated with preoperative embolization and subsequent en bloc resection. A 65-year-old man with metastatic pheochromocytoma presented with two weeks of worsening neck pain, left arm and leg weakness and paresthesia, and urinary incontinence. Magnetic resonance imaging showed a metastatic osseous lesion at C6 with severe stenosis and spinal cord compression. The patient underwent successful preoperative angiographic embolization with a liquid embolic agent followed by C5-C7 laminectomy, en bloc tumor resection, and C3-T2 posterior spinal fusion. Six weeks postoperatively, the patient reported improving strength and resolving neck pain and paresthesias. While there is no standard paradigm for the treatment of metastatic pheochromocytomas of the cervical spine, preoperative embolization may minimize intraoperative blood loss and hemodynamic instability during subsequent surgical resection.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"331-337"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suction thrombectomy of distal medium vessel occlusion using microcatheter during mechanical thrombectomy for acute ischemic stroke: A case series. 在急性缺血性脑卒中机械血栓清除术中使用微导管对远端中血管闭塞进行抽吸式血栓清除术：病例系列。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-12 DOI: 10.7461/jcen.2024.E2023.11.002
Eun-Oh Jeong, Hyon-Jo Kwon, Heewon Jeong, Han-Joo Lee, Kyung Hwan Kim, Hyeon-Song Koh
{"title":"Suction thrombectomy of distal medium vessel occlusion using microcatheter during mechanical thrombectomy for acute ischemic stroke: A case series.","authors":"Eun-Oh Jeong, Hyon-Jo Kwon, Heewon Jeong, Han-Joo Lee, Kyung Hwan Kim, Hyeon-Song Koh","doi":"10.7461/jcen.2024.E2023.11.002","DOIUrl":"10.7461/jcen.2024.E2023.11.002","url":null,"abstract":"<p><p>While mechanical thrombectomy is known to be effective for distal medium vessel occlusion (DMVO) as well as large vessel occlusion, tortuous DMVO are predisposed to vessel injury during stent retriever thrombectomy. Furthermore, getting access to the thrombus may be difficult during suction thrombectomy using a dedicated suction catheter. Most studies describe DMVO treatment using stent retrievers and dedicated suction catheters, but there are limited studies reporting DMVO treated with suction thrombectomy using a microcatheter. Herein, we describe three cases of DMVO treated with suction thrombectomy that was performed using a microcatheter and subsequently showed good results. Therefore, suction thrombectomy using a microcatheter is a viable alternative treatment for tortuous DMVO.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"311-317"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated ipsilateral abducens nerve palsy and contralateral homonymous hemianopsia associated with unruptured posterior cerebral artery aneurysm: A rare neurological finding. 与未破裂的大脑后动脉瘤相关的孤立的同侧外展神经麻痹和对侧同侧偏盲：罕见的神经系统发现。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-22 DOI: 10.7461/jcen.2024.E2023.07.002
Sandeep Mishra, Saurav Mishra, Sabina Regmi, Kanwaljeet Garg, Shailesh Gaikwad
{"title":"Isolated ipsilateral abducens nerve palsy and contralateral homonymous hemianopsia associated with unruptured posterior cerebral artery aneurysm: A rare neurological finding.","authors":"Sandeep Mishra, Saurav Mishra, Sabina Regmi, Kanwaljeet Garg, Shailesh Gaikwad","doi":"10.7461/jcen.2024.E2023.07.002","DOIUrl":"10.7461/jcen.2024.E2023.07.002","url":null,"abstract":"<p><p>Cranial nerve palsies can be presenting signs of intracranial aneurysms. There is a classic pairing between an aneurysmal vessel and adjacent nerves leading to cranial neuropathy. Isolated abducens nerve palsy can be a localizing sign of an unruptured vertebrobasilar circulation aneurysm. Aneurysms involving Anterior Inferior Cerebellar Artery (AICA) and Posterior Inferior Cerebellar Artery (PICA) have been reported to be associated with abducens nerve palsy. The symptoms in unruptured aneurysms are due to the mass effect on adjacent neurovascular structures. Most of the abducens nerve palsy resolves following microsurgical clipping. Here, we present a rare case of an unruptured Posterior Cerebral Artery (PCA) aneurysm presenting with abducens nerve palsy and diplopia associated with contralateral hemianopsia which markedly improved following endovascular coil embolization.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"318-323"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple telescopic stenting versus single flow diverter for the treatment of vertebral artery dissecting aneurysm. 治疗椎动脉剥脱性动脉瘤的多重伸缩支架与单一血流分流器。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-06-03 DOI: 10.7461/jcen.2024.E2024.02.006
Min-Seok Woo, Wonsoo Son, Dong-Hun Kang, Jaechan Park, Myungsoo Kim
{"title":"Multiple telescopic stenting versus single flow diverter for the treatment of vertebral artery dissecting aneurysm.","authors":"Min-Seok Woo, Wonsoo Son, Dong-Hun Kang, Jaechan Park, Myungsoo Kim","doi":"10.7461/jcen.2024.E2024.02.006","DOIUrl":"10.7461/jcen.2024.E2024.02.006","url":null,"abstract":"<p><strong>Objective: </strong>Reconstruction methods, including stent-assisted coiling, multiple telescopic stents, and flow diverters, are preferred modalities for the treatment of unruptured vertebral artery dissecting aneurysms (VADAs). We aimed to compare the clinical outcomes between two reconstructive flow diversion techniques: single flow diverter (FD) device and multiple telescopic stenting (TS).</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical data of 39 patients with unruptured VADAs. Of these, 17 patients were treated with multiple TS and 22 with a single FD device. Aneurysm characteristics and clinical outcomes were compared between the two groups.</p><p><strong>Results: </strong>All aneurysms included in this study successfully achieved flow diversion, regardless of the treatment modality and duration. However, the mean procedure duration to complete the diversion was shorter in the FD group. Subgroup analysis in TS group showed that there were no significant clinical differences between the low-profile visualized intraluminal support and Enterprise stents, except for the mean procedure duration.</p><p><strong>Conclusions: </strong>Both the single FD and multiple TS methods showed excellent angiographic and clinical outcomes in the treatment of unruptured VADAs. However, single FD required a shorter procedure duration and was associated with faster achievement of complete flow diversion.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"284-292"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two consecutive ruptured intracranial aneurysm in patient with multiple intracranial aneurysms. 多发性颅内动脉瘤患者连续两次颅内动脉瘤破裂。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-06-01 Epub Date: 2023-10-17 DOI: 10.7461/jcen.2023.E2023.08.010
Jonghyun Seong, Jongyeon Kim, Seungjin Lee, Byeongoh Kim
{"title":"Two consecutive ruptured intracranial aneurysm in patient with multiple intracranial aneurysms.","authors":"Jonghyun Seong, Jongyeon Kim, Seungjin Lee, Byeongoh Kim","doi":"10.7461/jcen.2023.E2023.08.010","DOIUrl":"10.7461/jcen.2023.E2023.08.010","url":null,"abstract":"<p><p>When aneurysmal subarachnoid hemorrhage due to multiple aneurysms is suspected, identifying the rupture site is essential to determine the exact surgical site, but it may not be easy. Even if embolization is adequately performed, complications may remain. Typical complications include rebleeding and hydrocephalus in the early phase and delayed cerebral ischemia in the delayed phase. Herein, we describe a case of rupture of an intracranial aneurysm after performing embolization for a different ruptured intracranial aneurysm in a patient with multiple intracranial aneurysms. Patients with multiple intracranial aneurysms need to be considered for closer observation than those with a single ruptured intracranial aneurysm, even if the patient's prognosis is good.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"174-180"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous femoral access: Stuck guide wire, decannulation difficulty due to unravelling and knotting. 经皮股骨入路：导丝卡住，因缠绕和打结而造成解管困难。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-06-01 Epub Date: 2024-03-27 DOI: 10.7461/jcen.2024.E2023.06.002
Bhanu Pratap Singh Chauhan, Binita Dholakia, Ashfaque Khan, Chirag Hirani, Satheesh Kumar, Dibya Jyoti Mahakul, Abhishek Katyal, Wajid Nazir, Daljit Singh
{"title":"Percutaneous femoral access: Stuck guide wire, decannulation difficulty due to unravelling and knotting.","authors":"Bhanu Pratap Singh Chauhan, Binita Dholakia, Ashfaque Khan, Chirag Hirani, Satheesh Kumar, Dibya Jyoti Mahakul, Abhishek Katyal, Wajid Nazir, Daljit Singh","doi":"10.7461/jcen.2024.E2023.06.002","DOIUrl":"10.7461/jcen.2024.E2023.06.002","url":null,"abstract":"<p><p>Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"223-226"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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