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Blocked Filter of Anti-Embolic Device During Carotid Artery Stenting: A Rare Occurrence Posing Challenging Diagnostic
Sarvesh C Mishra1, Vivek Singh1, Aviral Gupta2
1Radio-Diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IND.
Insights
Anti-embolic devices (AEDs) prevent clots during carotid artery stenting (CAS). A case study reveals AED filters can clog with thrombi, mimicking dissection and impacting blood flow.
Area of Science:
- Interventional Neurology
- Vascular Surgery
- Medical Device Technology
Background:
- Anti-embolic devices (AEDs) are crucial for preventing intracranial embolization during carotid artery stenting (CAS).
- AEDs aim to capture thrombi and debris generated during CAS to maintain cerebral blood flow.
- Potential complications include filter obstruction and procedural difficulties.
Observation:
- A specific case involved the obstruction of an AED filter by significant thrombus formation during CAS.
- This filter blockage led to a temporary reduction in intracranial blood flow.
- The clinical presentation mimicked arterial dissection due to the compromised blood flow.
Findings:
- The primary finding is the potential for AED filters to become occluded by emboli during CAS.
- Filter occlusion can transiently impede cerebral circulation, presenting a diagnostic challenge.
- Prompt filter removal restored normal intracranial blood flow in this case.
Implications:
- This case highlights the importance of monitoring for filter-related complications during CAS.
- Awareness of AED filter occlusion is crucial for accurate diagnosis and management.
- Further research may explore optimal filter designs or management strategies to mitigate this risk.
Abstract:
The use of anti-embolic devices (AED's) is a common practice in carotid artery stenting (CAS). It prevents the passage of blood clots and thrombi generated during the procedure from embolizing into the intracranial circulation. Disadvantages include the passage of small particles and complications related to advancement, deployment, and recovery of the filters. The filter of the AED can get clogged due to the high load of the emboli generated during CAS causing a slowing of the intracranial blood flow which normalizes once the filter is removed. Here, we are presenting a case of the filter of AED getting blocked due to entrapped thrombi or blood clots and mimicking dissection and, sharing our experiences associated with the event.
