Retrograde Snare-Assisted Rescue via Anterior Communicating Artery for Lost Access During Multiple Overlapping Pipeline Embolization Device Placement

Abstract

Background: The Pipeline embolization device (PED; ev3, Irvine, California, USA) has been used to divert flow away from an aneurysm sac. The risk of complications may increase for flow diversion with giant aneurysms because these cases may require multiple overlapping PEDs, which makes the technique highly complex.

Case description: We report a rescue technical strategy for lost access during multiple overlapping PED placement for a giant, fusiform cavernous aneurysm.

Conclusions: By using the collateral circulation as an alternative rescue route, intraprocedural loss of distal access may be salvaged.

Keywords: Overlapping; Pipeline; Rescue; Snare.