Five cases of acute non-terminal internal carotid artery occlusion followed by delayed spontaneous recanalization

Ryosuke, Suzuki; Ota, Terukazu; Furuta, Yasuyuki; Sakai, Yu; Fujitani, Shigeta; Ibayashi, Kenji; Abe, Arata; Ueda, Masayuki

doi:10.3995/jstroke.10669

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“…In Case 3, a dissecting lesion was suggested, and additional stenting was performed. In some patients with non-T occlusion, symptoms at the time of onset are relatively mild due to the presence of a collateral pathway 13) ; therefore, physicians may hesitate to initiate therapeutic intervention with endovascular treatment. In Case 3, symptoms at the time of onset were mild and the patient presented to our department on foot.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Retrograde Angiography via the Contralateral Carotid Artery in Mechanical Thrombectomy for Carotid Non-T Occlusion by Dual Puncture Technique

Uyama

Tsuto

Matsumoto

et al. 2021

JNET

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We report the effectiveness of retrograde angiography via the contralateral carotid angiography using a dual puncture technique in mechanical thrombectomy (MT) for non-T occlusion in patients with acute internal carotid artery (ICA) occlusion not involving the ICA terminus.Case Presentation: In the dual puncture technique, arterial puncture is performed at two sites: a balloon guiding catheter (BGC) is navigated to the ICA on the affected side and another catheter is navigated to the unaffected side. Thrombus retrieval is performed by manual aspiration through the BGC and MT using a stent retriever and/or aspiration device.Reperfusion is confirmed by retrograde angiography via the carotid artery on the unaffected side, with manual aspiration through the BGC on the affected side. Throughout the procedure, the BGC blocks the blood flow in the ICA on the affected side until reperfusion is confirmed. No distal embolization was occurred in our three patients treated using this technique. Conclusion: Application of the dual puncture technique on MT is recommended for non-T occlusion to prevent distal embolization.Keywords▶ mechanical thrombectomy, non-T occlusion, acute internal cerebral artery occlusion, retrograde angiography, contralateral carotid artery This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Section: Discussionmentioning

confidence: 99%