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Pull-Through Buddy Wire Technique for Endovascular Thrombectomy in Patients with Acute Ischemic Stroke: Technical Note

Neurointervention 2021년 16권 1호 p.64 ~ 69
Chiang Pin-Yi, Lin Yen-Heng, Huang Yu-Cheng, Lee Chung-Wei,
소속 상세정보
 ( Chiang Pin-Yi ) - National Taiwan University Hospital Department of Medical Imaging
 ( Lin Yen-Heng ) - National Taiwan University Hospital Department of Medical Imaging
 ( Huang Yu-Cheng ) - National Taiwan University Hospital Department of Medical Imaging
 ( Lee Chung-Wei ) - National Taiwan University Hospital Department of Medical Imaging

Abstract


Excessive tortuosity is a notable cause of failed endovascular thrombectomy for acute large-vessel occlusion stroke. Transcervical access (TCA) is a commonly proposed solution for overcoming this difficulty. However, the large-bore catheter usually used in TCA increases the risk of serious local complications. This paper presents a modified technique for TCA that uses a pull-through buddy wire (PTBW) to track a large-bore femoral guiding sheath (GS) into the carotid artery via a small carotid puncture site. The carotid puncture site can be easily managed through gentle manual compression. Two illustrative cases using this technique to deal with a large aortic arch and tortuous left common carotid artery are reported. In both cases, recanalization was achieved after successful GS placement. Using a PTBW is feasible in TCA.

키워드

Intracranial embolism; Thrombectomy; Endovascular procedures; Stroke

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