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Retrieval of Entrapped Embolic Protection Device during Carotid Artery Stenting: A Case Report
Gaoyang Fan1, Wenyuan Ma1, Chunhai Su1
1Institute of Central Nervous System Vascular Injury and Repair, Jining Medical Science Research Institute, The First People's Hospital of Jining, 272000 Jining, Shandong, China.
Annali Italiani Di Chirurgia
|January 16, 2025
Summary
Embolization protection device (EPD) entrapment during carotid artery stenting (CAS) is rare. Open surgery with concurrent carotid endarterectomy (CEA) provided a successful treatment strategy when endovascular retrieval failed.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid Artery Stenting (CAS) is a common procedure for treating carotid artery stenosis.
- Embolization Protection Devices (EPDs) are used during CAS to prevent stroke.
- Device entrapment during CAS is a rare but serious complication.
Purpose of the Study:
- To report a rare case of EPD entrapment during CAS.
- To discuss the management strategy for this complication.
- To highlight the role of open surgery and concurrent carotid endarterectomy (CEA).
Main Methods:
- A 71-year-old female patient experienced EPD entrapment after CAS.
- Initial endovascular retrieval attempts failed.
- An emergency open surgical procedure was performed, including EPD/stent retrieval and CEA.
Main Results:
- Successful retrieval of the entrapped EPD and stent via open surgery.
- Thrombectomy and carotid endarterectomy were performed.
- Post-operative angiography confirmed arterial patency.
- The patient was discharged without new neurological deficits.
Conclusions:
- EPD entrapment during CAS necessitates a prompt shift to open surgical intervention if endovascular methods fail.
- Concurrent CEA during open repair offers a comprehensive solution.
- Multidisciplinary collaboration is crucial for managing complex vascular interventions.
