Abstract 238: Detachment of stent retriever device in mechanical thrombectomy for acute ischemic stroke

Introduction/Purpose Mechanical thrombectomy in acute ischemic stroke brings out some undesired events during the procedure. Device related complications is one of the challenging problems. The detachment of trevo stent retriever is a rare situation and can be handled in different ways. Materials/Methods 82 year old male patient was referred to ER with a sudden hemiparesis in the last 70 minutes. He was given apiksaban therapy for atrial fibrillation and known to use regularly. He was diagnosed with left MCA thrombosis which seemed to be the cause of this stroke. As he was under DOAC therapy the only way was to perform EVT. The procedure lasted in 18 minutes and we had a first pass effect. But the final screening showed that the cage of the trevo stent retriever was still in the MCA territory letting the blood flow properly. So instead of removing the remnant stent, we decided to give dual antiplatelet therapy because of the MCA stenosis. The patient covered from this period with mild neurologic defisits but after 2 months he passed away because of rectal bleeding which was suppposed to be the result of a underlying colorectal cancer. Results Stent retriever detachment is not common in the literature. Even trevo stent retriever detachments is much more rare. In this case the vascular curves and the ICAD of the arteries seem to cause this complication even the procedure was smooth. Conclusion It is important to evaluate the device complications properly. Mechanical removement can be applied if possible but it will be good to remember that sometimes medical approach can also stabilise the situation as well.