scholarly journals In-Hospital Mechanical Thrombectomy: A Case Report

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 22-26
Author(s):  
Tsong-Hai Lee
Keyword(s):  
Tooth Extraction ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Early Recognition ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Acute Onset ◽  
Interventional Treatment ◽  
Left Internal Carotid Artery ◽  
Remarkable Recovery

We report on a case of a 59-year-old female patient with atrial fibrillation who received edoxaban. She withdrew edoxaban before tooth extraction. She was brought to our emergency department due to acute onset of left-side weakness. Under the impression of acute ischemic stroke, edoxaban was replaced with aspirin. However, the patient suffered from recurrent cerebral embolism with conscious disturbance. Urgent mechanical thrombectomy was performed due to left internal carotid artery occlusion. Remarkable recovery was noted on the second day after thrombectomy. She was discharged with mild neurological deficit. We suggest that early recognition, assessment, and interventional treatment for patients with in-hospital strokes are favorable for stroke outcome.

scholarly journals Successful Bridging Therapy in a 103-Year-Old Woman with Acute Terminal Internal Carotid Artery Occlusion

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 9-14
Author(s):  
Trung Quoc Nguyen ◽  
Hoang Thi Phan ◽  
Tinh Quang Dang ◽  
Vu Thanh Tran ◽  
Thang Huy Nguyen
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Intravenous Thrombolysis ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Left Internal Carotid Artery ◽  
Bridging Therapy ◽  
Nihss Score ◽  
Current Guidelines

The efficacy of intravenous thrombolysis and endovascular therapy and their favorable treatment outcomes have been established in clinical trials irrespective of age. Current guidelines do not recommend an age limit in selecting eligible patients for reperfusion treatment as long as other criteria are satisfied. A 103-year-old woman was admitted at our hospital within 1 h of stroke onset secondary to a left internal carotid artery terminus occlusion. On admission, her National Institutes of Health Stroke Scale (NIHSS) score was 30, with a small left thalamic diffusion restriction lesion on MRI. Her medical history included paroxysmal atrial fibrillation, prior myocardial infarction, hypertension, chronic kidney disease, and diabetes mellitus. Her pre-stroke modified Rankin Scale score was 0, and she was fully independent before stroke. Once intravenous thrombolysis was started, the patient successfully underwent mechanical thrombectomy, and thrombolysis in cerebral infarction-3 recanalization was achieved 225 min after symptom onset. She showed dramatic recovery (NIHSS score of 5 after 48 h) and was discharged on day 7 with a modified Rankin Score of 1. To our knowledge, our patient is the second oldest documented patient who successfully underwent bridging therapy for stroke.

scholarly journals Anesthetic Management for Spine Surgery in a Patient with Left Internal Carotid Artery Occlusion and Penetrating Aortic Ulcer: A Case Report

2021 ◽  
Vol 27 (2) ◽  
pp. 106-109
Author(s):  
Misoon Lee ◽  
Dasom Choi ◽  
Bon Sung Koo ◽  
Sung-Hwan Cho
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Anesthetic Management ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Left Internal Carotid Artery ◽  
Penetrating Aortic Ulcer ◽  
Mortality And Morbidity

A key challenge of anesthesia is to provide patients with safe and optimized anesthetic management to improve prognosis and minimize mortality and morbidity. To this end, the anesthesiologist should comprehensively understand the patient’s physical status through pre-anesthetic assessment and carefully monitor the patient during surgery. Several types of novel patient-monitoring devices may be useful to achieve this purpose. We report a case of anesthetic management in a patient with left internal carotid artery occlusion and penetrating aortic ulcer.

scholarly journals Carotid–carotid crossover bypass after mechanical thrombectomy for internal carotid artery occlusion due to plaque from stenosed innominate artery

2021 ◽  
Vol 12 ◽  
pp. 480
Author(s):  
Tomoaki Murakami ◽  
Shingo Toyota ◽  
Takuya Suematsu ◽  
Yuki Wada ◽  
Takeshi Shimizu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Innominate Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Crossover Bypass ◽  
The Right ◽  
Innominate Artery Stenosis

Background: The treatment for internal carotid artery occlusion (ICAO) due to innominate artery stenosis is not well established. We herein describe a case of carotid–carotid crossover bypass and common carotid artery (CCA) ligation after mechanical thrombectomy for ICAO due to a plaque from the stenosed innominate artery. Case Description: A 70-year-old man was transferred to our hospital because of left-sided hemiparalysis. Head magnetic resonance imaging/angiography showed a cerebral infarction in the right middle cerebral artery area and the right ICAO due to a plaque from the stenosed innominate artery. Immediately, we performed mechanical thrombectomy and successfully attained partial revascularization (Thrombolysis in Cerebral Infarction Grade 2B). After a conference with cardiovascular group, we performed carotid–carotid crossover bypass and the right CCA ligation. The treatment was successful, and no complications occurred. Conclusion: Carotid–carotid crossover bypass and CCA ligation may be a better option for innominate artery stenosis in selected patients.

scholarly journals Duret hemorrhage due to broad brain infarction with left internal carotid artery occlusion

Nosotchu ◽  
2013 ◽  
Vol 35 (3) ◽  
pp. 227-231
Author(s):  
Wataru Shiraishi ◽  
Ryu Matsuo ◽  
Shuji Arakawa ◽  
Masahiro Kamouchi ◽  
Takanari Kitazono
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Brain Infarction ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Left Internal Carotid Artery

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.

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