Trapped Embolic Protection Device: A Salvage Technique

After carotid artery stenting, retrieval of the embolic protection device can sometimes be difficult due to incomplete stent expansion, stent fracture, vasospasm, and vessel tortuosity. In this technical report, we describe a novel rescue technique used in a patient with diffuse calcific atherosclerosis of the left common and proximal left internal carotid arteries who underwent left internal carotid artery stenting with cerebral protection and in whom, due to an under-expanded proximal carotid stent strut in relation to a densely calcified plaque, we were initially unable to advance the retrieval device.

[1]  D. Niemann,et al.  Retained distal protection device during carotid artery stenting necessitating carotid endarterectomy: A complication and management considerations , 2018, Surgical neurology international.

[2]  D. Wirthlin,et al.  Surgical management for retained distal embolic protection device and fractured guidewire after carotid artery stenting , 2016, Journal of Surgical Case Reports.

[3]  K. Kazekawa,et al.  A manual carotid compression technique to overcome difficult filter protection device retrieval during carotid artery stenting. , 2015, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[4]  Gelin Xu,et al.  Risk Factors and Complications Associated with Difficult Retrieval of Embolic Protection Devices in Carotid Artery Stenting , 2012, Cardiovascular and Interventional Radiology.

[5]  G. Caldito,et al.  Protected Carotid Artery Stenting in Patients at High Risk for Carotid Endarterectomy , 2011, Southern medical journal.

[6]  H. Cloft,et al.  Rescue Retrieval of AngioGuard Embolic Capture System after Failure of Capture Sheath Retrieval in Carotid Angioplasty and Stenting , 2008, American Journal of Neuroradiology.

[7]  B. Uretsky,et al.  Entrapment of a Cerebral Embolic Protection Device , 2006, Vascular and endovascular surgery.

[8]  R. Smalling,et al.  Difficult retrieval of the EPI filterwire with a 5 French FR4 coronary catheter following carotid stenting , 2006, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[9]  N. Niedermaier,et al.  Embolic protection devices for carotid artery stenting: better results than stenting without protection? , 2004, European heart journal.