Surgical Rescue Retrieval of a Filter Protection Device in Carotid Artery Stenting with Stent Deformation: Case Report and Literature Review.

Background: Despite the development of neuroendovascular treatment, device-related complications requiring surgical procedures remain. We report a case requiring surgical retrieval of a filter protection device in carotid artery stenting (CAS) with an open-cell stent, due to stent deformation, and review past reports on CAS in which surgical retrieval of devices was required.

Case Description: An 82-year-old man underwent CAS for symptomatic right internal carotid artery stenosis with severe calcification and tortuosity. Immediately after placement of the open-cell stent, stent deformation was detected and the filter protection device could not be retrieved. All noninvasive device retrieval attempts failed, and the device was ultimately retrieved surgically. After surgery, right cerebral infarction progressed increased, but no permanent deficit was observed.

Conclusions: As the treatment of cerebrovascular disease shifts from surgical to endovascular approaches, surgeons must be familiar with devices and techniques to manage complications of neuroendovascular treatment.