Medtronic (covidien) received report that a pipeline flex did not open during treatment of a fusiform aneurysm in the distal, right, cavernous internal carotid artery (ica).The pipeline flex was deployed and landed distally with difficulty due to tortuous anatomy.The distal end of the pipeline flex was well apposed, but the middle third of the device did not open sufficiently through the aneurysm and cavernous sinus curve.Techniques to improve opening included using a support catheter, loading and unloading the system, pinning the microcatheter and pushing the wire, and resheathing the device two times.The middle section of the pipeline flex continued to be flattened and stretched through tortuous anatomy.The pipeline flex was resheathed and removed from the patient, then disposed of by staff.The case was rescheduled.Patient condition was stable post-procedure.
|