Skip Navigation LinksHome > March 2012 - Volume 70 - Issue > Rescue Forced-Suction Thrombectomy Using the Reperfusion Cat...
doi: 10.1097/NEU.0b013e31822fefc4
Operative Technique

Rescue Forced-Suction Thrombectomy Using the Reperfusion Catheter of the Penumbra System for Thromboembolism During Coil Embolization of Ruptured Cerebral Aneurysms

Kang, Dong-Hun MD*,‡; Kim, Yong-Sun MD*; Park, Jaechan MD; Hwang, Yang-Ha MD§

Collapse Box


BACKGROUND: No definite conclusive management has been established in the treatment of thromboembolism during coil embolization of cerebral aneurysms. To date, intravenous heparin, intra-arterial fibrinolytic agent, and intravenous or intra-arterial glycoprotein IIb-IIIa inhibitors have been the mainstay of treatment. However, in practice, 2 major concerns may arise; first, recanalization is not always possible despite every effort of management; second, rehemorrhagic risk is increased if the event occurred during coiling of ruptured cerebral aneurysms.

OBJECTIVE: We introduce a new endovascular mechanical thrombectomy technique to overcome the aforementioned concerns.

METHODS: In 4 refractory cases involving conventional pharmaceutical treatment of thromboembolism during coiling, we practiced rescue suction thrombectomy using the reperfusion catheter of the Penumbra System.

RESULTS: All 4 of the patients to whom this technique was applied were successfully recanalized; 2 were Thrombolysis In Cerebral Infarction scale of 2b and the other 2 were a scale of 3. Recanalization was confirmed at the follow-up angiography at least 12 hours after the procedure. No complication associated with this technique occurred.

CONCLUSION: Forced-suction thrombectomy is a simple modification of the Penumbra System. Based on our preliminary data, this technique can play a role as an adjuvant management or as a last resort combined with injection of glycoprotein IIb-IIIa inhibitors in thromboembolic events that occur in coil embolization of a ruptured cerebral aneurysm.

Copyright © by the Congress of Neurological Surgeons


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.