RESUMEN
Despite growing evidence over the last few years of the efficacy and safety of direct thrombus aspiration using a large bore distal access catheter as a type of mechanical thrombectomy procedure in acute stroke large-vessel occlusion patients, the experience and evidence of this technique for managing thromboembolic complications in endovascular aneurysm treatment is still limited and little research is available regarding this topic. We present a case of a thromboembolic occlusion of the left middle cerebral artery during the preprocedural angiograms of a large and fusiform left internal carotid artery aneurysm. This complication was successfully managed by navigating an already-placed distal access catheter intended for support during the opening of the flow-diverting stent; therefore, the thrombus was manually aspirated for two minutes, and Thrombolysis in Cerebral Infarction (TICI) scale 3 flow was restored. This case should encourage the use of a distal access catheter, already placed for aneurysm treatment, to perform zero-delay direct thrombus aspiration as a rescue approach for thromboembolic complications during endovascular treatments.
Asunto(s)
Procedimientos Endovasculares , Aneurisma Intracraneal , Trombectomía , Tromboembolia , Humanos , Trombectomía/métodos , Trombectomía/efectos adversos , Aneurisma Intracraneal/cirugía , Procedimientos Endovasculares/métodos , Procedimientos Endovasculares/efectos adversos , Tromboembolia/etiología , Masculino , Femenino , Anciano , Succión/métodos , Succión/instrumentación , Persona de Mediana EdadRESUMEN
As minimally invasive technology continues to be developed and refined, surgeons must be discerning in choosing the safest, cost-effective surgical approach associated with the best outcomes for each individual patient. Vaginal hysterectomy can be successfully accomplished even in challenging situations, such as previous pelvic surgery, nulliparity, uterine enlargement, or obesity. Vaginal hysterectomy should be considered the primary route for treatment of benign disease.