scholarly journals Mechanical thrombectomy utilising a collateral pathway in a patient with dysgenesis of the internal carotid artery

2018 ◽  
Vol 25 (1) ◽  
pp. 54-57
Author(s):  
Jun Tsukano ◽  
Satoshi Kurabe ◽  
Tsutomu Sugai ◽  
Manabu Wada ◽  
Takashi Kumagai
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Left Middle Cerebral Artery ◽  
Collateral Pathway ◽  
Guiding Catheter ◽  
Left Middle

We describe a case of acute middle cerebral artery occlusion in a patient with ipsilateral internal carotid artery dysgenesis successfully treated with mechanical thrombectomy utilising a collateral pathway. During the procedure, a triaxial system using a balloon guiding catheter, flexible large lumen aspiration catheter and stent retriever was advanced from the left vertebral artery to the occluded left middle cerebral artery through the left posterior communicating artery. Because proximal aspiration from the balloon guiding catheter alone might have insufficient suction force due to the retrograde blood flow from large vascular communications (e.g. vertebral artery union), the tip of the flexible large lumen aspiration catheter was set at the proximal left middle cerebral artery, and distal aspiration was added during stent retrieval. A thrombolysis in cerebral infarction 2b result was achieved after the first pass. In this case, identification of carotid canal hypoplasia on computed tomography allowed for an immediate attempt of this alternative approach, avoiding a delay in the time to reperfusion.

scholarly journals A Case of Occlusive Radiation Vasculopathy Presenting as Bilateral Internal Carotid Artery, Left Middle Cerebral Artery Occlusion and Literature Review

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 91-96
Author(s):  
Yung-Chuan Huang ◽  
Shin-Leh Huang ◽  
Hon-Man Liu ◽  
Hou-Chang Chiu
Keyword(s):  
Carotid Artery ◽  
Literature Review ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Tongue Cancer ◽  
Artery Occlusion ◽  
Left Middle Cerebral Artery ◽  
Left Middle

Radiation vasculopathy is one of the rare causes of ischemic stroke. Carotid stenosis with large volume infarction may occur years after radiation therapy for head or neck cancer. We report a case of a patient with bilateral internal carotid artery occlusion presenting with left middle cerebral artery infarct 10 years after receiving treatment for tongue cancer. A literature review and discussion of treatment for such patients are presented.

scholarly journals Treatment of Middle Cerebral Artery Occlusion and Internal Carotid Artery Dissection with Combined Mechanical Thrombectomy and Stenting of the Internal Carotid Artery

2013 ◽  
Vol 26 (1) ◽  
pp. 84-88 ◽  
Author(s):  
A. Wetter ◽  
Mi-Rim Shin ◽  
D. Meila ◽  
F. Brassel ◽  
M. Schlunz-Hendann
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Intravenous Thrombolysis ◽  
Artery Dissection ◽  
Severe Stroke ◽  
The Right

We describe a case of combined mechanical thrombectomy of the right middle cerebral artery and stent angioplasty of the right internal carotid artery in a severe stroke caused by arterio-arterial embolism due to a traumatic dissection of the internal carotid artery. The patient was admitted with an NIHSS score of 19 and was discharged from hospital with a score of 2. Three months later neurological examination disclosed no pathological findings. The case demonstrates the crucial role of interventional procedures in the treatment of severe stroke where intravenous thrombolysis has little prospect of success.

scholarly journals Luxury Perfusion Producing Sensory Aphasia

2021 ◽  
pp. 46-49
Author(s):  
Daiki Sakai ◽  
Ryuji Sakakibara ◽  
Fuyuki Tateno ◽  
Yosuke Aiba
Keyword(s):  
Brain Injury ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Internal Carotid ◽  
Left Middle Cerebral Artery ◽  
Sensory Aphasia ◽  
Luxury Perfusion ◽  
Old Japanese ◽  
Left Middle

We describe the case of an 86-year-old Japanese man who, by luxury perfusion after spontaneous recanalization of the left middle cerebral artery/internal carotid artery, produced acute transient sensory aphasia. This rare phenomenon is thought to be caused by reperfusion brain injury.

Emergency embolectomy for embolic occlusion of the middle cerebral artery after internal carotid artery balloon test occlusion

1992 ◽  
Vol 77 (1) ◽  
pp. 134-138 ◽  
Author(s):  
Mark E. Linskey ◽  
Laligam N. Sekhar ◽  
Stephen T. Hecht
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Excellent Outcome ◽  
Balloon Test Occlusion ◽  
Temporary Occlusion

✓ Balloon test occlusion of the internal carotid artery (ICA) is useful in preoperatively assessing the risk of temporary occlusion or permanent sacrifice of the carotid artery. The incidence of symptomatic complications from this procedure is 1.7%. The case is reported of a 57-year-old woman in whom a balloon test occlusion of the left ICA was attempted. She developed a left ICA dissection/occlusion with subsequent embolization to the left middle cerebral artery, leading to right-sided hemiplegia and expressive aphasia. She was successfully treated by an emergency embolectomy followed by surgical repair of the left ICA, with an excellent outcome. This case represents the most serious complication encountered by the authors in more than 300 balloon test occlusions. Means of avoiding this complication during balloon test occlusion as well as the important factors in managing this problem are emphasized.

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.

Sign in / Sign up

Export Citation Format

Share Document