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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 301-304
DOI: 10.1055/s-0044-1787083
Case Report

Repeated Middle Cerebral Artery Occlusion Possibly Caused by Endoluminal Injury Due to Stent Clot Retriever: A Case Report

Tomotaka Ohshima
1   Neuroendovascular Therapy Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
,
Shigeru Miyachi
1   Neuroendovascular Therapy Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
2   Department of Neurosurgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
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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.

Keywords

acute ischemic stroke - mechanical thrombectomy - recurrent occlusion - stent clot retriever

Authors' Contributions

Tomotaka Ohshima was involved in conceptualization, designing, literature search, and manuscript preparation. Shigeru Miyachi helped in manuscript editing and review.




Publication History

Article published online:
05 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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