Retrieval of distorted pipeline embolic device using snare-loop

J Vasc Interv Neurol. 2014 Dec;7(5):1-4.


Background: Flow-diverter stents are increasingly being used in the endovascular treatment of intracranial aneurysms. Because of this increased usage, the occurrence of stent malpositioning, intra-arterial distortion, or migration will likely increase as well.

Methods: We describe the conformational twisting and deformity of a pipeline embolic device (PED) stent (Covidien, EV3) within the carotid artery during stent placement, with the subsequent immediate removal of the stent by using an endovascular snare-loop to successfully remove the device.

Results: The PED can be successfully removed using a snare-loop device when indicated. In this case, following removal of the initial PED, the aneurysms can be successfully treated with the placement of a second PED.

Conclusion: It is critical to have a contingency plan for the removal of malpositioned or otherwise deformed stents that could potentially represent significant sources of iatrogenic stroke.

Keywords: Intracranial; Pipeline embolic device; aneurysm; retrieval; snare loop.