title: Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms.
abstract: OBJECTIVE
  To examine the safety and efficacy of mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms.
  
  
  METHODS
  Between June 2011 and June 2015, 631 consecutive patients with ruptured intracranial aneurysms underwent coil embolization at 6 hospitals. Among 53 patients who had thromboembolic complications, 15 patients harboring 15 aneurysms underwent rescue mechanical thrombectomy with a retrievable stent for the treatment of thromboembolic occlusion during the coiling of ruptured aneurysms. The patients' clinical and radiologic outcomes were retrospectively reviewed.
  
  
  RESULTS
  Of the 15 aneurysms, coiling alone was used for 13 (86.7%), and stent-assisted coiling was performed for 2 (13.3%). Thromboembolic occlusion most frequently occurred distal to the aneurysm (n=10, 66.7%), followed by proximal to the aneurysm (n=3, 20%), and at the coil-parent vessel interface (n=2, 13.3%). All patients underwent mechanical thrombectomy with a retrievable stent, including 5 patients who were initially treated with an IA tirofiban infusion. Complete recanalization (Thrombolysis in Cerebral Infarction (TICI) 3) was obtained in 13 (86.7%) and partial recanalization (TICI 2b) in 2 (13.3%). Two patients who had received IA tirofiban before mechanical thrombectomy had hemorrhagic complications. At 6 months after discharge, 9 patients had a modified Rankin Scale (mRS) score of 1, 3 patients were mRS 2, 1 patient was mRS 3, 1 patient was mRS 4, and 1 patient was mRS 6.
  
  
  CONCLUSIONS
  Rescue mechanical thrombectomy using a retrievable stent can be a useful treatment for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms.
authors: Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors: Jun Hyong
authors: http://orcid.org/0000-0002-8529-6757
authors: JH
authors: Ahn
authors: Department of Neurosurgery, Hallym University Dongtan Sacred Heart Hospital, Hwasung, Korea.
authors: Hyo Sub
authors: HS
authors: Jun
authors: Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors: Joon Ho
authors: JH
authors: Song
authors: Department of Neurosurgery, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors: Byung Moon
authors: BM
authors: Cho
authors: Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors: Ho Kook
authors: HK
authors: Lee
authors: Department of Neurosurgery, Dongguk University Ilsan Hospital, Goyang, Korea.
authors: Byong-Cheol
authors: BC
authors: Kim
authors: Department of Neurosurgery, Inha University Hospital, Incheon, Korea.
authors: Dong-Keun
authors: DK
authors: Hyun
authors: Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors: In Bok
authors: IB
authors: Chang
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D017131:Thrombectomy / Q000379:methods; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D014443:Tyrosine; D000077466:Tirofiban
keywords: Aneurysm; Coil; Thrombectomy