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KMID : 1155820210160010064
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Neurointervention
2021 Volume.16 No. 1 p.64 ~ p.69
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Pull-Through Buddy Wire Technique for Endovascular Thrombectomy in Patients with Acute Ischemic Stroke: Technical Note
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Chiang Pin-Yi
Lin Yen-Heng
Huang Yu-Cheng
Lee Chung-Wei
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Abstract
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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.
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KEYWORD
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Intracranial embolism, Thrombectomy, Endovascular procedures, Stroke
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