scholarly journals Mechanical Thrombectomy of Primary Distal Anterior Cerebral Artery Occlusion: A Case Report

2019 ◽  
Vol 11 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Hironori Haruyama ◽  
Junji Uno ◽  
Kenta Takahara ◽  
Yosuke Kawano ◽  
Naoki Maehara ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Anterior Cerebral Artery ◽  
Rare Condition ◽  
Computed Tomographic Angiography ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Computed Tomographic

Objective: Primary anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. We herein report on the efficacy of mechanical thrombectomy (MT) in treating the distal ACA occlusion in a clinical setting. Case Presentation: A 76-year-old woman presented with a sudden onset of right hemiparesis. Computed tomographic angiography and perfusion imaging and subsequent analysis with RAPID software revealed acute left ACA occlusion with salvageable penumbra. The patient obtained a score of 11 on the National Institutes of Health Stroke Scale. MT was performed for occlusion of the left ACA (A4), and successful reperfusion (Thrombolysis in Cerebral Infarction score of 3) was achieved on the first attempt using a stent retriever. The patient’s recovery progressed well, and she was discharged 13 days after admission with a modified Rankin Scale score of 1. Conclusion: This case report demonstrates the clinical efficacy, safety, and favorable clinical outcome of treating a primary distal ACA occlusion with MT.

scholarly journals Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli

2018 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Hyo S Kwak ◽  
Jung S Park
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Thrombolytic Agent ◽  
Mechanical Thrombectomy ◽  
Computed Tomographic Angiography ◽  
Sudden Onset ◽  
Aspiration Thrombectomy ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Left Middle

Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.

scholarly journals Successful Mechanical Thrombectomy of a Middle Cerebral Artery Occlusion 14 Hours after Stroke Onset

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Anelia Dietmann ◽  
Kety Wha-Vei Hsieh ◽  
Andrea M. Humm ◽  
Claudio L. Bassetti ◽  
Urs Fischer ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Symptom Onset ◽  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Stroke Onset ◽  
Neurological Deficits ◽  
Therapeutic Window ◽  
Left Middle Cerebral Artery ◽  
Large Diffusion

A 54-year-old patient presented with mild right-sided weakness of hand and face with a National Institutes of Health Stroke Scale (NIHSS) of 2 and occlusion of the left middle cerebral artery (MCA) in the M1 segment with a large perfusion deficit on computed tomography (CT). Due to mild neurological deficits no IVT was performed. Nine hours after symptom onset the patient gradually deteriorated with a NIHSS fluctuating between 9 and 15. MRI showed a persistent occlusion of the MCA with a large diffusion-perfusion mismatch. Immediate endovascular thrombectomy was performed 14 hours after symptom onset with complete recanalization and complete clinical recovery. Although mechanical thrombectomy is generally considered an effective alternative strategy up to 8 hours after stroke onset, selected patients with a large diffusion/perfusion mismatch and small infarct cores may benefit from an expanded therapeutic window.

Mechanical Recanalization for Acute Embolic Occlusion at the Origin of the Superior Mesenteric Artery

2017 ◽  
Vol 51 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Yoichi Miura ◽  
Tomohiro Araki ◽  
Mio Terashima ◽  
Junya Tsuboi ◽  
Yasuhiro Saito ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mechanical Thrombectomy ◽  
Chronic Atrial Fibrillation ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Large Artery ◽  
Intestinal Necrosis ◽  
Computed Tomographic ◽  
Solitaire Fr

Purpose: We report a combined technique consisting of thrombectomy and thromboaspiration for the treatment of acute embolic occlusion of the superior mesenteric artery (SMA) at the origin. Case: A 90-year-old female with chronic atrial fibrillation had a sudden onset of abdominal pain and hematochezia due to acute embolic occlusion at the origin of the SMA. Computed tomographic findings showed reversible bowel wall ischemia. We performed mechanical thrombectomy using the Solitaire FR revascularization device, a self-expanding and fully retrievable stent-based thrombectomy system for acute intracranial large artery occlusion, combined with manual aspiration through a 6F guiding sheath placed at the SMA origin via a right brachial approach. Prompt and complete recanalization of the SMA was obtained without distal embolism, and intestinal necrosis was avoided. Conclusion: Combined endovascular procedures of mechanical thrombectomy using the Solitaire FR with thromboaspiration may allow prompt recanalization, clot removal, and prevention of distal embolism and therefore would be a new therapy for acute embolic occlusion at the origin of the SMA.

Mechanical Thrombectomy for Acute Anterior Cerebral Artery Occlusion

2018 ◽  
Vol 120 ◽  
pp. e957-e961 ◽  
Author(s):  
Junji Uno ◽  
Katsuharu Kameda ◽  
Ryosuke Otsuji ◽  
Nice Ren ◽  
Shintaro Nagaoka ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Anterior Cerebral Artery ◽  
Artery Occlusion ◽  
Cerebral Artery Occlusion
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