M2 Onyx Resolute Stenting

Another case of “distal” balloon mounted stent placement — this is 2023 btw.  we really could use a dedicated balloon-mounted head stent

Waiting for two days with head of bed down and pressure up — before doing the right thing

Interesting how perfusinon here did not pick up the severity of flow decrease — angio is still gold standard

Severe focal stenosis (arrow) on background of a larger stenotic lesion.  Marked delay in M3 flow (dashed arrows)

Measurements — one thing that we need is a sub 2mm stent.  Really, we can put a 2 mm into a 1.5 mm vessel, but its not ideal.  And navigability drops off tremendously after they go beyond 2.5 mm

Microcatheter interrogation

Right triaxial support is key.  The best ones are either Sofia 5 EX or Phenom Plus 120 mm.  Getting right up to lesion helps.

Slow inflation is important when stent is oversized.  Cant be too careful here…

7 ATM is really minimal… maybe 6.5  The table coming with the stent is key

When it works it really looks fantastic, right

See hyperperfusion in the starvation territory….  drop that pressure.  its not an LVO thrombectomy.

See other cases on Archives page