J Korean Med Sci.  2009 Oct;24(5):967-969. 10.3346/jkms.2009.24.5.967.

Pseudo-no-Reflow Phenomenon in Carotid Artery Stenting using FilterWire EX: Successful Recovery by Aspiration Thrombectomy

• Han SH
• Kang WC
• Ahn TH
• Shin EK

• KMID: 1782025
• DOI: http://doi.org/10.3346/jkms.2009.24.5.967

Abstract

Distal protection devices such as FilterWire EX have been widely used in carotid artery stenting, however, the large amount of atherothrombotic debris entrapped in the filter could reduce or stop antegrade flow. We present a case of pseudo-no-reflow phenomenon after postdilatation of the stent in a patient with asymptomatic carotid artery stenosis. After several passes using an Export Aspiration catheter, normal flow in the internal carotid artery was restored. Aspiration thrombectomy can successfully recover pseudo-no-reflow phenomenon.

Keyword

Carotid Artery Stenting; Distal Protection Device; Pseudo-no Reflow Phenomenon; Aspiration Thrombectomy

MeSH Terms

Aged
Blood Vessel Prosthesis Implantation
Carotid Arteries/radiography/surgery
Carotid Stenosis/diagnosis/radiography/*surgery
Humans
Male
*No-Reflow Phenomenon
Stents
Thrombectomy/*instrumentation

Figure

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  Fig. 1 Carotid angiogram showed severe stenotic lesion in the right internal carotid artery. RAO, right anterior oblique.

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  Fig. 2 (A) After postdilatation of the stent, sudden antegrade flow interruption (arrow) developed proximal to FilterWire EX location. (B) Several passes of Export Aspiration catheter (arrow) was performed before FilterWire removal. RAO, right anterior oblique.

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  Fig. 3 After aspiration thrombectomy, antegrade flow was fully restored. RAO, right anterior oblique.

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  Fig. 4 After retrieval of FilterWire EX, whitish debris was noted within the basket.

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