Faculty Collaboration Database

Cross-circulation thrombectomy with use of a stent retriever: A case report. Interv Neuroradiol 2017 Aug;23(4):422-426

Date

05/10/2017

Pubmed ID

28480772

Pubmed Central ID

PMC5684909

DOI

10.1177/1591019917706191

Scopus ID

2-s2.0-85026655470 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Introduction The efficacy of the endovascular treatment of acute ischemic stroke has been substantiated by several recent randomized clinical trials. While intra-arterial therapy has significantly evolved in recent years, anatomic cerebrovascular variants and disease burden can present challenges to timely recanalization. We present the first reported case of anterior-to-posterior mechanical clot retrieval with use of a stent retriever. Case description A 53-year-old man presented with basilar artery thrombosis. Endovascular mechanical clot retrieval was performed. The typical, antegrade, access to the basilar artery thrombus was precluded by the findings of a hypoplastic left vertebral artery and an occluded proximal right vertebral artery. Given a number of factors including the patient's worsening symptoms and the high morbidity and mortality associated with basilar stroke, cross-circulation-anterior-to-posterior-intra-arterial therapy was performed. Thrombectomy of the basilar thrombus was achieved via the right internal carotid artery and right posterior communicating artery. Conclusion To our knowledge, we report the first case of cross-circulation, anterior-to-posterior thrombectomy, with the use of a stent-retriever device. Cross-circulation stroke treatment may be beneficial in cases of proximal vessel occlusion or anatomical constraints. Larger studies will need to evaluate the safety and efficacy of these approaches.

Author List

Sultan-Qurraie A, Rozansky G, Cox JA, Lazzaro M

Author

Marc A. Lazzaro MD Associate Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Basilar Artery
Cerebral Angiography
Computed Tomography Angiography
Endovascular Procedures
Humans
Male
Middle Aged
Radiography, Interventional
Stents
Stroke
Thrombectomy
Thrombosis