Added assessment of middle cerebral artery and atrial fibrillation to FLAIR vascular hyperintensity-DWI mismatch would improve the outcome prediction of acute infarction in patients with acute internal carotid artery occlusion

2019 ◽  
Vol 40 (12) ◽  
pp. 2617-2624 ◽  
Author(s):  
Tao Yuan ◽  
Guoli Ren ◽  
Xianning Hu ◽  
Lina Geng ◽  
Xueqing Li ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Outcome Prediction ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Acute Infarction

scholarly journals Combined interventional and surgical treatment of tandem middle cerebral artery embolus and internal carotid artery occlusion: case report

2018 ◽  
Vol 129 (3) ◽  
pp. 718-722 ◽  
Author(s):  
Mark B. Frenkel ◽  
Jaclyn J. Renfrow ◽  
Jasmeet Singh ◽  
Nitin Garg ◽  
Stacey Q. Wolfe
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Carotid Revascularization ◽  
Threatening Condition

Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion. This case illustrates the shortest reported interval between tPA infusion and open surgical intervention for carotid revascularization, as well as the role of direct carotid artery access for mechanical thrombectomy. The authors also describe the use of a temporizing femoral artery–to–ICA shunt to maintain cerebral perfusion in the setting of ICA occlusion.

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