Atypical Incomplete Detachment Following PulseRider Deployment

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  • Goto Shunsaku
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Izumi Takashi
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Nishihori Masahiro
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Araki Yoshio
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Yokoyama Kinya
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Uda Kenji
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Saito Ryuta
    Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

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<p>Objective: Owing to the limited time since the introduction of the PulseRider (PR), inconsequential or rare complications that clinicians should be aware of remain unreported yet. Here, we report a rare complication of incomplete detachment.</p><p>Case Presentation: A 50-year-old male underwent PR-assisted coil embolization for a basilar tip aneurysm. Coiling was completed, and the detachment procedure was performed using a detachment machine; the success signal was observed. The delivery microcatheter was subsequently advanced back up to the proximal markers, and no reapproximation of the proximal markers, which indicates successful detachment, was observed. However, only one of the proximal markers returned to the microcatheter, and incomplete detachment of only one leg was detected. Ultimately, electrical detachment was not possible, and physical separation by tension was achieved.</p><p>Conclusion: Our case report presents a rare case of a detachment problem in the PR. The PR could not be detached, although the signal revealed successful detachment. Therefore, careful withdrawal of the delivery wire by checking not only the proximal markers but also the behavior of the entire PR and coil complex is important.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 16 (8), 409-412, 2022

    特定非営利活動法人 日本脳神経血管内治療学会

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