Dornbos, d., and powers, c.J.(2017).Acute distal migration of a flow diverting stent.Journal of clinical neuroscience.Doi:1 0.1016/j.Jocn.2017.05.009.The pipeline device remains implanted in the patient; product analysis cannot be performed.The reported event could not be confirmed.An event cause could not be conclusively determined from the provided information.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
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Medtronic literature review found a report of pipeline migration after implantation as well as cerebral infarction.The patient underwent pipeline implantation in the treatment of a left paraclinoid aneurysm.Intra-operatively, the patient was found to have a 4.1 x 5.0 x 4.8 mm aneurysm in the vicinity of the superior hypophyseal artery.A 3.5 x 12 mm pipeline device was placed without complication under therapeutic heparinization.Immediate post-placement angiography revealed stagnation within the aneurysm dome with no evidence of impaired flow.Upon emergence from general anesthesia, the patient was initially moving all extremities symmetrically.While still on the operative table, the patient developed acute right hemiparesis and a right facial droop.Angiography was emergently repeated, which revealed complete thrombosis of the stent and proximal mca.The pipeline was noted to have migrated to the supraclinoid ica, after which the patient received intra-arterial tissue plasminogen activator and attempted thrombus aspiration.The patient was maintained on abciximab overnight.The article states that despite tici 2b revascularization, the patient experienced a dominant left mca infarct.
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