title: Mechanical revascularization of acute iatrogenic anterior cerebral artery occlusions: use of a new coaxial dual-lumen balloon catheter results in rapid access and flow restoration.
abstract: Acute iatrogenic occlusion of cerebral vessels is a risk during the performance of neuroendovascular procedures. Most commonly this is a result of thrombus formation within the vessel, thromboembolism or an acute vasospastic response. There are several options for flow restoration including pharmacological, mechanical and microsurgical. Mechanical flow restoration, usually by thrombectomy, is typically performed in large cerebral vessels. Current mechanical thrombectomy devices have limited utility in smaller vessels that are more difficult to access, such as the anterior cerebral artery (ACA). We present two cases where successful flow restoration of an intraoperative acutely occluded or thrombotic ACA was rapidly achieved by balloon dilation using a new coaxial dual-lumen balloon catheter. The time elapsed from the decision to use the balloon catheter until revascularization for each patient was 5 min and 46 s (case 1) and 10 min and 25 s (case 2).
authors.affiliation: Division of Neurosurgery, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: James
authors.forename: John Richard
authors.initials: JR
authors.lastname: Lamm
authors.forename: Hilal A
authors.initials: HA
authors.lastname: Kanaan
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D020771:Anterior Cerebral Artery / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000601:surgery*; D057785:Catheters; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery; D017131:Thrombectomy; D013923:Thromboembolism / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology
chemical_list: D010975:Platelet Aggregation Inhibitors