Gelfoam embolization for distal, medium vessel injury during mechanical thrombectomy in acute stroke: A case report  

作　　者：Ji Yun Kang Kyung Sik Yi Sang-Hoon Cha Chi-Hoon Choi Yook Kim Jisun Lee Bum Sang Cho 

机构地区：[1]Department of Radiology,Chungbuk National University Hospital,Cheongju 28644,South Korea [2]College of Medicine and Medical Research Institute,Chungbuk National University,Cheongju 28644,South Korea

出　　处：《World Journal of Clinical Cases》2021年第20期5668-5674,共7页世界临床病例杂志

基　　金：Supported by the Research Grant of the Chungbuk National University Hospital in 2020.

摘　　要：BACKGROUND Arterial perforation has inevitably increased as endovascular treatments have become more common for intracranial large vessel occlusions,and even distal,medium vessel occlusions.A distal,medium vessel has a tortuous course and thinner wall compared to large arteries,making it more susceptible to damage.Here,we review the treatment strategies for arterial perforation during mechanical thrombectomy,and we report the case of a patient treated with gelfoam embolization.CASE SUMMARY A 63-year-old woman presented to the emergency department with sudden neurologic symptoms of right hemiparesis and global aphasia.The initial National Institutes of Health Stroke Scale score was 15.Computed tomography(CT)and CT angiography revealed hyperacute infarction and emergent arterial occlusion of the left middle cerebral artery M2-3 portion.During endovascular mechanical thrombectomy,arterial rupture occurred.The patient’s vital signs were stable,but delayed angiography showed persistent active bleeding.Therefore,selective embolization of the injured artery was performed using gelfoam.Subsequent left vertebral and internal carotid angiography was performed to confirm hemostasis.A localized subarachnoid hemorrhage(SAH)was confirmed on a follow-up CT scan.A repeated CT scan after 12 d showed resolution of the SAH,and rebleeding did not occur.CONCLUSION Rescue embolization with gelfoam could be considered an additional option in distal,medium vessel perforation.

关 键 词：GELFOAM EMBOLIZATION Acute ischemic stroke Mechanical thrombectomy Arterial perforation Case report 

分 类 号：R651.12[医药卫生—外科学]