Management of per operative bleeding during mechanical thrombectomy
Presentations of a complication encountered by a specialist. The case is analyzed and discussed live by the panel.
Case: Perforation of the artery with microwire while passing the clot (point of the perforation is behind or at the level of the clot)
Performed by Dr Gregory Gascou
Angiographic clues to identify: you suddenly felt a drop in resistance and the wire is moving loosely not following anatomical basis of the course of the artery
Clinical clues to identify: bradycardia + hypertension
How to confirm:
How to avoid: always pass the clot with J shape wire
What to do:
Technique of Prof. Tudor Jovin:
Technique of Dr Marc Ribo:
Technique of Prof. Christophe Cognard:
Technique of Dr Gregory Gascou:
Do not let the perforation stop you from performing effective thrombectomy.
It is likely that the patient will be more harmed by ischemic consequences of failed reperfusion than a bleeding, if managed properly.
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