How to differentiate intracranial atherosclerotic disease or vasospasms after mechanical thrombectomy. Be patient or vasodilator is the secret?
| Autor: | Bruno Amaral, Celso Saito, Darcio Nalli, Henrique Carrete Junior, Igor Pagiola, Michel Frudit |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Vasospasms
medicine.medical_specialty medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery Occlusion Technical Note medicine Endovascular treatment cardiovascular diseases Stroke Thrombectomy Computed tomography angiography Ischemic stroke medicine.diagnostic_test Cerebral infarction business.industry Vasospasm Thrombolysis medicine.disease Stenosis Middle cerebral artery Cardiology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Cerebrovascular and Endovascular Neurosurgery |
| ISSN: | 2287-3139 2234-8565 |
| DOI: | 10.7461/jcen.2021.e2020.05.001 |
| Popis: | Here we describe a successful mechanical thrombectomy (MT) for acute large vessel occlusion in stroke treatment with one passage (thrombolysis in cerebral infarction, TICI 3). Immediately after the withdrawing of the stent retriever, a narrowing of the middle cerebral artery was diagnosed. The rate of vasospasms during this procedure can be as higher as 41% (range from 6-41%). Here we describe our protocol when a narrowing of the artery is visualized after a stent retriever is withdrawn. A patient presented in our emergency room with National Institute of Health Stroke Scale (NIHSS) of 21, Alberta Stroke Program Early CT Score (ASPECTS) 8, computed tomography angiography revealed occlusion of the M1 segment and MT was indicated. One passage TICI Ⅲ was achieved. After that, the image showed a narrowing of the artery. We present one case of a spasm after stent retriever technique for MT, we injected vasodilator and the artery became normal in a few minutes differentiating between atheromatous stenosis and vasospasm. We present a technical note that can help to make the differentiation of vasospasm or atheromatous disease after MT with the stent retriever technique. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|