PDF(Pubmed)
Abstract：
In acute ischemic stroke, various endovascular approaches have been reported with high recanalization rates and good clinical outcomes. However, the best device or technique for the first attempt at mechanical thrombectomy remains a matter of debate. We report a case in which endoluminal injury from initial stent clot retrieval possibly caused repeated middle cerebral artery occlusion. A 74-year-old man presented with left-sided hemiplegia and was diagnosed with a right internal carotid artery occlusion. He underwent endovascular thrombectomy using a stent clot retriever. Although complete recanalization was achieved in the first pass, repeated middle cerebral artery occlusion occurred. Angiography revealed an irregular inner surface and thrombus formation in the superior branch of the second segment of the right middle cerebral artery. There is a risk of endoluminal injury due to stent retrieval, especially using a large sized stent against small branches. Antiplatelet therapy may be effective for preventing recurrent occlusion. Key Messages We report a case in which endoluminal injury from initial stent clot retrieval possibly caused repeated middle cerebral artery occlusion. There is a risk of endoluminal injury due to stent retrieval, especially using a large sized stent against nonvisible small branches.
摘要：
在急性缺血性中风中，据报道,各种血管内入路血管再通率高,临床结局好.然而,首次尝试机械血栓切除术的最佳装置或技术仍存在争议。我们报告了一例初始支架凝块取出引起的腔内损伤可能导致反复的大脑中动脉闭塞。一名74岁的男子出现左侧偏瘫，并被诊断为右颈内动脉闭塞。他使用支架凝块取回器接受了血管内血栓切除术。尽管在第一关中实现了完全的再通，反复发生大脑中动脉闭塞。血管造影显示右大脑中动脉第二段上支的内表面不规则和血栓形成。由于支架取出，存在腔内损伤的风险，特别是使用大尺寸支架对小分支。抗血小板治疗可有效预防复发性闭塞。主要信息我们报告了一个病例，其中最初的支架凝块取出引起的腔内损伤可能导致反复的大脑中动脉闭塞。由于支架取出，存在腔内损伤的风险，特别是使用大尺寸支架对不可见的小分支。
