Direct Advancement of Balloon-Guide Catheter Distal to the Carotid Free-Floating Thrombus Achieves Smart Mechanical Thrombectomy

Direct Advancement of Balloon-Guide Catheter Distal to the Carotid Free-Floating Thrombus Achieves Smart Mechanical Thrombectomy

A 68-year-old man with bladder cancer developed sudden dysarthria and left hemiplegia. MRI revealed occlusion of the right middle cerebral artery (MCA). Cerebral angiography revealed a large carotid free-floating thrombus (CFFT) at the origin of the right internal carotid artery (ICA) and right M1 o...

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Veröffentlicht in:Curēus (Palo Alto, CA) CA), 2022-02, Vol.14 (2), p.e22439
Hauptverfasser: Inoue, Hiroyasu, Oomura, Masahiro, Nishikawa, Yusuke, Mase, Mitsuhito, Matsukawa, Noriyuki
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Neurology
Neurosurgery
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container_title Curēus (Palo Alto, CA)
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creator Inoue, Hiroyasu
Oomura, Masahiro
Nishikawa, Yusuke
Mase, Mitsuhito
Matsukawa, Noriyuki
description A 68-year-old man with bladder cancer developed sudden dysarthria and left hemiplegia. MRI revealed occlusion of the right middle cerebral artery (MCA). Cerebral angiography revealed a large carotid free-floating thrombus (CFFT) at the origin of the right internal carotid artery (ICA) and right M1 occlusion. A balloon-guide catheter (BGC) was directly guided distal to the CFFT. Mechanical thrombectomy (MT) was performed on the M1 occlusion while the balloon was inflated to block antegrade blood flow, and good recanalization was achieved. To continue processing the CFFT, the deflated BGC was pulled to the common carotid artery, and the thrombus dispersed into the external carotid artery (ECA). Subsequently, the patient's symptoms improved. Directly advancing a BGC distally to a CFFT may be a useful treatment strategy for tandem lesions with carotid free-floating thrombi.
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title Direct Advancement of Balloon-Guide Catheter Distal to the Carotid Free-Floating Thrombus Achieves Smart Mechanical Thrombectomy
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