Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2015; 7(6): 139-142
Published online Jun 28, 2015. doi: 10.4329/wjr.v7.i6.139
Endovascular retrieval of a prematurely deployed covered stent
Jefferson T Miley, Gustavo J Rodriguez, Ramachandra P Tummala
Jefferson T Miley, Seton Brain and Spine Institute, Dell Medical School, the University of Texas at Austin, El Paso, TX 79905, United States
Gustavo J Rodriguez, Department of Neurology and Radiology, Texas Tech University Health Sciences Center, El Paso, TX 79905, United States
Ramachandra P Tummala, Department of Neurosurgery, University of Minnesota, Minneapolis, MN 55455, United States
Author contributions: Miley JT manuscript designed this work, collected the data and drafted the main work; Rodriguez GJ contributed to reviewing the literature; Rodriguez GJ and Tummala RP gave the critical review of the manuscript; Tummala RP approved to the final manuscript.
Ethics approval: The procedure was reviewed and approved by the University of Minnesota/Fairview Institutional Review Board.
Informed consent: The patient provided informed written consent prior to the procedure.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Gustavo J Rodriguez, MD, Associate Professor, Department of Neurology and Radiology, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, United States.
Telephone: +1-915-2155911 Fax: +1-915-5456705
Received: September 16, 2014
Peer-review started: September 16, 2014
First decision: October 28, 2014
Revised: April 20, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: June 28, 2015

Several techniques have been reported to address different endovascular device failures. We report the case of a premature deployment of a covered balloon mounted stent during endovascular repair of a post-traumatic carotid-cavernous fistula (CCF). A 50-year-old male suffered a fall resulting in loss of consciousness and multiple facial fractures. Five weeks later, he developed decreased left visual acuity, proptosis, chemosis, limited eye movements and cranial/orbit bruit. Cerebral angiography demonstrated a direct left CCF and endovascular repair with a 5.0 mm × 19 mm covered stent was planned. Once in the lacerum segment, increased resistance was encountered and the stent was withdrawn resulting in premature deployment. A 3 mm × 9 mm balloon was advanced over an exchange length microwire and through the stent lumen. Once distal to the stent, the balloon was inflated and slowly pulled back in contact with the stent. All devices were successfully withdrawn as a unit. The use of a balloon to retrieve a prematurely deployed balloon mounted stent is a potential rescue option if leaving the stent in situ carries risks.

Keywords: Stent retrieval, Covered stent, Premature stent deployment

Core tip: Increasingly complex neurovascular lesions are now amenable to endovascular therapy due to the development of new devices and techniques. However, malfunction or failure of these devices remains a potential hurdle to a successful treatment. Consequently, a growing body of reports describing rescue and salvage techniques have emerged. In this report, we discuss the endovascular retrieval of a prematurely deployed covered stent during the treatment of a traumatic carotid-cavernous fistula.