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Case Reports
. 2023 Apr 6;18(6):2112-2115.
doi: 10.1016/j.radcr.2023.02.059. eCollection 2023 Jun.

Rescue retrieval of a trapped embolic protection device using a JB2-type balloon catheter

Yasuyuki Tatsuta  1 , Tatsuya Ogino  1 , Hideki Endo  1 , Suguru Sakurai  1 , Hirohiko Nakamura  1
Affiliations
Case Reports

Rescue retrieval of a trapped embolic protection device using a JB2-type balloon catheter

Yasuyuki Tatsuta et al. Radiol Case Rep. .

Abstract

Carotid artery stenting is a treatment option for patients with significant symptomatic or asymptomatic carotid artery stenosis. Although use of an embolic protection device during carotid artery stenting can prevent distal embolization, device retrieval after stenting can be difficult. In this report, during an embolic protection device retrieval, it was not possible to advance recapture catheters through the distal flare segment of the stent because the device wire would catch on the flare or become jammed between the flare and vessel wall. Then, an extension wire was connected to the end of the device and a 5.2-Fr JB2-type balloon catheter was advanced over the wire, which was able to pass through the stent. The use of a 5.2-Fr JB2-type balloon catheter to retrieve a trapped embolic protection device is feasible and effective if standard maneuvers fail.

Keywords: Balloon catheter; Carotid artery stenting; Complication; Embolic protection device; Endovascular treatment; Extension wire.

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Figures

Fig 1
Fig. 1
(A, B) Angiography before carotid artery stenting demonstrated severe right cervical internal carotid artery stenosis. (C, D) Angiography after stenting demonstrated significant improvement of the stenosis and good stent wall apposition. A, C: right anterior oblique view, B, D: lateral view.
Fig 2
Fig. 2
(A, B) The recapture catheter (black arrows) could not advance through the distal flare segment of the stent (asterisk). (C, D) A 5.2-Fr JB2-type balloon catheter (white arrows) could pass through the stent without inflating the balloon.
Fig 3
Fig. 3
The distance between the 2 markers of the 5.2-Fr JB2-type balloon catheter is about 11 mm. The tip stiffness and JB2 shape should enable shifting the EPD wire to allow passage through the stent. The EPD can be retrieved into the balloon catheter without resistance (A, B). EPD: embolic protection device.
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