2018 年 12 巻 9 号 p. 463-468
Objective: A method to deal with situations in which the protective sleeves of the Pipeline Flex embolization device (Medtronic, Minneapolis, MN, USA) cannot be released in its placement due to strong resistance to the delivery wire is presented.
Case Presentation: The patient was a 60-year-old woman with symptomatic aneurysm in the cavernous portion of the left internal carotid artery. We attempted to navigate the Pipeline Flex to, and place it in, the target vessel, but the resistance to the delivery wire in the microcatheter was so strong that it was totally impossible to expose the Pipeline Flex from the catheter tip. Therefore, we expanded the tip of the Pipeline Flex ex vivo, resheathed it after releasing the protective sleeves, and attempted to place the device again with success.
Conclusion: While this method cannot be recommended, it may be effective if there is strong resistance in releasing the protective sleeves.
