Stent-retriever Use for post-SAH Vasospasm Angioplasty
Here is a case of bilateral severe ACA spasm post ACOM aneurysm rupture. Long segments of proximal and distal ACA spasm offer excellent target for stent-retriever angioplasty
Notice three vessels arising from the ACOM complex (see ACA page for more info)
A week later there is perfusion abnormality and clinical deterioration
left A1 injection — Headway 021
Trevo 4×30 stent-retriever in place
Resheathing the stent-triever. Do not pull like in a thrombectomy case. Just deploy, leave in there for a minute, and resheath, like Pipeline Flex
Proximal balloon plasty (Transform 3×5)
Right side, deployment
All three ACOM-related vessels are treated
Pre and post. its not perfect by any means. but much better.
left side. also partial but better for sure.