Contralateral Mechanical Thrombectomy of Partial Deployed Stent Retrieval for Acute Anterior Inferior Cerebellar Artery Occlusion
| Autor: | Hyungon Lee, Byung-Sam Choi, Sung-Chul Jin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Vascular occlusion 03 medical and health sciences 0302 clinical medicine Cerebellum medicine.artery Internal medicine Occlusion medicine Humans Thrombectomy Computed tomography angiography medicine.diagnostic_test business.industry Endovascular Procedures Stent Cerebral Arteries Middle Aged Neurovascular bundle Anterior inferior cerebellar artery Stroke Posterior inferior cerebellar artery Cerebral blood flow 030220 oncology & carcinogenesis Cardiology Stents Surgery Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 129:318-321 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.06.044 |
| Popis: | Background Acute anterior inferior cerebellar artery (AICA) occlusion is considered an acute ischemic stroke requiring medical treatment without mechanical thrombectomy (MT). There is a procedural risk of parent vessel rupture, but neurologic deficits are not generally severe. Here, we report a case of MT performed using partially deployed stent retrieval for acute AICA occlusion. Case Description A 53-year-old male patient presented with acute-onset drowsiness and visual disturbance. The initial National Institutes of Health Stroke Scale score of the patient was 5. Computed tomography angiography showed no definite vascular occlusion, but computed tomography perfusion imaging suggested decreased cerebral blood flow and cerebral blood volume, with an increased mean transit time and time to peak in the left posterior inferior cerebellar artery territory. Conventional angiography showed occlusion of the left proximal AICA and posterior inferior cerebellar artery cortical branches, which were reconstituted by the muscular branches of the left vertebral artery. We decided to perform intra-arterial thrombectomy for proximal left AICA occlusion because the patient's symptoms seemed to be aggravated, and neurologic deficits were not expected. MT was performed using a Trevo stent (Stryker Neurovascular, Fremont, California, USA) in the left proximal AICA via a right vertebral artery approach and resulted in complete recanalization of the occluded AICA. The patient recovered and had an National Institutes of Health Stroke Scale score of 0 at 1 day after MT. Conclusions Our case suggests that MT can be performed in a highly selective manner in patients with the occlusion of a posterior circulation branch, such as the AICA, and yield a good clinical outcome. |
| Databáze: | OpenAIRE |
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