• Haowen Xu, Sheng Guan, Chao Liu, Li Wang, Baojun Yan, Hongjie Han, and Tao Quan.
• Department of Neurointerventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
• World Neurosurg. 2019 Jan 1; 121: 19-23.

BackgroundVessel perforation is a serious technical complication during mechanical thrombectomy (MT) for the treatment of acute ischemic stroke with large vessel occlusion. Routine rescue strategy includes balloon occlusion for tamponade, procedure suspension, and lowering or normalizing blood pressure. However, this complication is still associated with poor outcome and high mortality.MethodsIn this paper, the authors report their experience by using glue to embolize the ruptured vessel secondary to microcatheter/microwire perforation, preventing further deterioration in clinical outcome. Rescue glue embolization was attempted in 2 patients who developed intraprocedural vessel perforation while trying to gain access through the blocked artery with a microcatheter/microwire.ResultsThe ruptured vessels were effectively occluded. Stent retriever thrombectomies were then continued, and TICI 2b and 3 recanalizations were achieved. Both patients' neurologic status improved.ConclusionsThe key benefit of this method exists in embolizing the ruptured vessel without affecting the following MT. We propose the rescue glue embolization is simple yet effective in managing vessel perforation complication during MT.Copyright © 2018 Elsevier Inc. All rights reserved.

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