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

Right ICA

Left ICA

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

Post right

Pre and post. its not perfect by any means. but much better.

left side. also partial but better for sure.