ABSTRACT
Endovascular thrombectomy in acute ischaemic stroke commonly uses aspiration catheters, either alone or in combination with stent retrievers. The Penumbra Aspiration System (Penumbra, Alameda, California, USA) was first approved by the US Food and Drug Administration in 2007, with low reported device-related complications. We present a case of a previously unreported complication related to malfunction of a Penumbra aspiration catheter during stroke thrombectomy resulting in a carotid-cavernous fistula.
Subject(s)
Brain Ischemia , Fistula , Stroke , Humans , Stroke/diagnostic imaging , Stroke/etiology , Stroke/surgery , Brain Ischemia/complications , Thrombectomy/adverse effects , Thrombectomy/methods , Catheters/adverse effects , Stents/adverse effects , Fistula/complications , Treatment OutcomeABSTRACT
Endovascular thrombectomy in acute ischaemic stroke commonly uses aspiration catheters, either alone or in combination with stent retrievers. The Penumbra Aspiration System (Penumbra, Alameda, California, USA) was first approved by the US Food and Drug Administration in 2007, with low reported device-related complications. We present a case of a previously unreported complication related to malfunction of a Penumbra aspiration catheter during stroke thrombectomy resulting in a carotid-cavernous fistula.
Subject(s)
Carotid-Cavernous Sinus Fistula , Computed Tomography Angiography/methods , Equipment Failure , Infarction, Middle Cerebral Artery , Intraoperative Complications , Ischemic Stroke , Middle Cerebral Artery , Thrombectomy , Vascular Access Devices/adverse effects , Aged , Carotid-Cavernous Sinus Fistula/diagnosis , Carotid-Cavernous Sinus Fistula/etiology , Carotid-Cavernous Sinus Fistula/surgery , Equipment Failure Analysis , Female , Humans , Infarction, Middle Cerebral Artery/complications , Infarction, Middle Cerebral Artery/diagnosis , Infarction, Middle Cerebral Artery/surgery , Intraoperative Complications/diagnosis , Intraoperative Complications/surgery , Ischemic Stroke/etiology , Ischemic Stroke/physiopathology , Ischemic Stroke/therapy , Middle Cerebral Artery/diagnostic imaging , Middle Cerebral Artery/surgery , Thrombectomy/adverse effects , Thrombectomy/instrumentation , Thrombectomy/methods , Treatment OutcomeABSTRACT
As many as 130,000 inferior vena cava (IVC) filters are placed annually, with as few as 5,000 retrieved a year for patients who no longer require protection from deep vein thrombosis. Superior vena cava (SVC) filter placement is an even less common occurrence and is usually reserved for special cases. Furthermore, the simultaneous placement of IVC and SVC filters is most rare, whereas simultaneous IVC and SVC filter removal has not been reported in the literature. We present a case and a novel technique for successful concurrent removal of IVC and SVC filters in a patient.
ABSTRACT
Congenital anomalies of the coronary sinus and veins have been well documented, but only one instance of an anomalous small cardiac vein draining into the superior vena cava (SVC) has been reported. The majority of patients with anomalies of the coronary venous system are asymptomatic, but these variants are important to document as they may have clinically significant implications in the management and possible interventions patients may receive. This report describes an anomalous connection from the coronary venous system to the superior vena cava discovered incidentally in a patient with SVC syndrome and end-stage renal disease (ESRD). This may reflect a congenital variant which accommodated collateral flow to bypass the fully occluded SVC. Alternatively, it may be the result of repeated venoplasty of the stenotic SVC which opened an iatrogenic tract that was maintained and vascularized over time.
