Microcatheter delivery of embolic protection devices for acute atherosclerotic tandem occlusion: patient series
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Acute atherosclerotic tandem occlusions of the internal carotid artery (ICA) present significant technical challenges for endovascular intervention. Optimal strategies for the efficient and safe deployment of embolic protection devices (EPDs) in this context remain to be established, as conventional approaches often necessitate multiple device exchanges, prolonging procedural time and potentially increasing risk. OBSERVATIONS: In this retrospective series, 16 consecutive patients with acute ischemic stroke due to ICA occlusion underwent endovascular therapy utilizing a microcatheter-facilitated EPD (MICRO-EPD) delivery technique. This novel approach, leveraging a 0.027-inch microcatheter for direct EPD deployment, eliminated the need for standard exchange maneuvers and reduced procedural complexity. Technical success was achieved in all cases, with a median puncture-to-recanalization time of 55 minutes. At 90 days, 56.3% of patients achieved favorable functional outcomes (modified Rankin Scale score ≤ 2). Symptomatic intracranial hemorrhage and mortality each occurred in 1 patient (6.3%). No device-related technical failures or unanticipated complications were observed. LESSONS: The MICRO-EPD technique demonstrates a promising advance in the management of acute atherosclerotic tandem occlusions, offering a simplified, safe, and effective method for EPD deployment. This strategy has the potential to optimize procedural efficiency and improve patient outcomes, meriting further prospective evaluation in broader clinical settings. https://thejns.org/doi/10.3171/CASE25622.
DOI: 10.3171/case25622
Authors: Wang Chen, Xianjun Wang, Hongxing Han, Qinjian Sun
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415916278
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