Mild angioplasty with a stent retriever for acute atherothrombotic middle cerebral artery occlusion: A case report

• Main Authors: Yosuke Moteki, Atsushi Shimizu, Akikazu Nakamura, Hayato Yamahata, Tomonori Kobayashi
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: Interdisciplinary Neurosurgery
• Subjects: Middle cerebral artery occlusion; Percutaneous transcatheter angioplasty; Plaque shift; Stroke
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214751920304175

Mechanical thrombectomy has become the most effective treatment for intracranial artery occlusion; however, it is difficult to recanalize acute arterial occlusion resulting from atherothrombotic causes. We describe a 44-year-old man diagnosed with cerebral infarction associated with acute right middle cerebral artery occlusion. During emergency mechanical thrombectomy, atheromatous disease was identified by deployment of a stent retriever. The stent retriever was reinserted within a microcatheter and retrieved. After the procedure, the right middle cerebral artery was recanalized, although severe stenosis persisted. We recommend mild angioplasty with a stent retriever for patients with atherothrombotic intracranial artery occlusion as an optional treatment for avoiding damage to the vessel wall, and plaque shift to the perforating arteries.