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Carotid-cavernous fistula following mechanical thrombectomy of the tortuous internal carotid artery:A case report

世界临床病例杂志 2023年第25期11卷 6005-6011页

作者： Lin-Zhuo Qu Guang-Hui Dong En-Bo Zhu Ming-Quan Lin Guang-Lin Liu Hong-Jian Guan Department of Medicine Yanbian UniversityYanji 133000Jilin ProvinceChina Department of Neurology Affiliated Hospital of Yanbian UniversityYanji 133000Jilin ProvinceChina

BACKGROUND A carotid-cavernous fistula(CCF)is an abnormal connection between the internal carotid artery(ICA)and the cavernous *** direct CCFs typically result from trauma or as an iatrogenic complication of neuroendovascular procedures,they can occur as surgery-related complications after mechanical thrombectomy(MT).With the widespread use of MT in patients with acute ischemic stroke complicated with large vessel occlusion,it is important to document CCF following MT and how to avoid *** this study,we present a case of a patient who developed a CCF following MT and describe in detail the characteristics of ICA tortuosity in this *** SUMMARY A 60-year-old woman experienced weakness in the left upper and lower limbs as well as difficulty speaking for 4 *** neurological examination revealed left central facial paralysis and left hemiplegia,with a National Institutes of Health Stroke Scale score of *** magnetic resonance imaging revealed an acute cerebral infarction in the right basal ganglia and radial *** resonance angiography demonstrated an occlusion of the right ICA and middle cerebral *** subtraction angiography demonstrated distal occlusion of the cervical segment of the right *** performed suction combined with stent ***,postoperative angiography was performed,which showed a right *** month later,CCF embolization was performed,and the patient’s clinical symptoms have significantly improved 5 mo after the *** Although a CCF is a rare complication after MT,it should be *** the tortuosity of the internal carotid-cavernous sinus may help predict the complexity of MT and avoid this complication.

关键词： Carotid-cavernous fistula Complication mechanical thrombectomy Internal carotid artery Tortuosity Case report

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mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report

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World Journal of Clinical Cases 2021年第10期9卷 2268-2273页

作者： Hong-Bo Zhang Pian Wang Yan Wang Jiang-Hong Wang Zheng Li Rong Li Department of Neurology Chengdu Fifth People's HospitalChengdu 611130Sichuan ProvinceChina

BACKGROUND mechanical thrombectomy(MT)has been demonstrated to be useful for the treatment of ischemic stroke in patients with large vessel ***,recanalization by MT is not recommended for distal vessels such as second-order branches of the middle cerebral artery and posterior inferior cerebellar artery(PICA).Because of the small size and tortuosity of these arteries,the risks of using the available endovascular devices outweigh the benefits of ***,MT appears to be effective in patients with primary distal vessel occlusion in eloquent areas,those with a high National Institutes of Health Stroke Scale score,and those ineligible for recombinant tissue plasminogen activator ***,we report the use of MT for treating acute occlusion of the PICA using a directaspiration first-pass technique(ADAPT).CASE SUMMARY In this case,the patient received acute occlusion of the PICA with ADAPT when right internal carotid artery stenting was *** With the introduction of advanced endovascular devices,MT may now be a feasible treatment for acute occlusion of the PICA.

关键词： Posterior inferior cerebellar artery mechanical thrombectomy Ischemic stroke Carotid artery stent Neurovascular interventions Case report

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Anticoagulant treatment for pulmonary embolism in patient with cerebral hemorrhage secondary to mechanical thrombectomy: A case report

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World Journal of Clinical Cases 2021年第33期9卷 10279-10285页

作者： Xiang-Ting Chen Qian Zhang Chang-Qing Zhou Yu-Fu Han Qing-Qing Cao Department of Neurology Bishan HospitalFirst Affiliated Hospital of Chongqing Medical UniversityChongqing 402760China

BACKGROUND Cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy is characterized by high morbidity,disability and *** the patient also has severe pulmonary embolism(PE)at the same time,the treatment becomes more *** report describes the treatment strategy for a patient with PE and cerebral hemorrhage secondary to cerebral embolism after mechanical *** SUMMARY A 70-year-old woman presented to our emergency department with right-sided hemiplegia and mixed aphasia of 2.5 h *** was diagnosed with left cerebral embolism,left internal carotid artery occlusion,PE and left calf intramuscular vein *** mechanical thrombectomy,brain magnetic resonance imaging showed cerebral infarction with basal ganglia *** observed changes in cerebral hemorrhage on serial monitoring of brain computed tomography and adjusted the dose of anticoagulant *** 3 wk of treatment,the patient’s neurological and respiratory symptoms significantly improved,and a favorable prognosis was *** Anticoagulation could be a potential option for PE accompanied by hemorrhagic transformation of an ischemic infarct.

关键词： Pulmonary embolism Brain embolism Cerebral hemorrhage mechanical thrombectomy Anticoagulation Case report

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Gelfoam embolization for distal, medium vessel injury during mechanical thrombectomy in acute stroke: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5668-5674页

作者： Ji Yun Kang Kyung Sik Yi Sang-Hoon Cha Chi-Hoon Choi Yook Kim Jisun Lee Bum Sang Cho Department of Radiology Chungbuk National University HospitalCheongju 28644South Korea College of Medicine and Medical Research Institute Chungbuk National UniversityCheongju 28644South Korea

BACKGROUND Arterial perforation has inevitably increased as endovascular treatments have become more common for intracranial large vessel occlusions,and even distal,medium vessel occlusions.A distal,medium vessel has a tortuous course and thinner wall compared to large arteries,making it more susceptible to ***,we review the treatment strategies for arterial perforation during mechanical thrombectomy,and we report the case of a patient treated with gelfoam *** SUMMARY A 63-year-old woman presented to the emergency department with sudden neurologic symptoms of right hemiparesis and global *** initial National Institutes of Health Stroke Scale score was *** tomography(CT)and CT angiography revealed hyperacute infarction and emergent arterial occlusion of the left middle cerebral artery M2-3 *** endovascular mechanical thrombectomy,arterial rupture *** patient’s vital signs were stable,but delayed angiography showed persistent active ***,selective embolization of the injured artery was performed using *** left vertebral and internal carotid angiography was performed to confirm hemostasis.A localized subarachnoid hemorrhage(SAH)was confirmed on a follow-up CT scan.A repeated CT scan after 12 d showed resolution of the SAH,and rebleeding did not *** Rescue embolization with gelfoam could be considered an additional option in distal,medium vessel perforation.

关键词： Gelfoam Embolization Acute ischemic stroke mechanical thrombectomy Arterial perforation Case report

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A Unique Case of Successful mechanical thrombectomy and Stenting of Cabrol Graft: A Case Report

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World Journal of Cardiovascular Diseases 2016年第9期6卷 295-299页

作者： Puneeth Shridhar Triston Smith Ramzi Khalil David Lasorda Young Jae Chun Department of Bioengineering University of Pittsburgh Pittsburgh USA Department of Cardiology Wheeling Hospital Wheeling USA Department of Cardiology Allegheny General Hospital Pittsburgh USA Department of Industrial Engineering University of Pittsburgh Pittsburgh USA McGowan Institute for Regenerative Medicine Pittsburgh USA

Cabrol technique and its modification are used as second line or bailout procedure in reimplantation of coronary arteries after aortic root replacement. Percutaneous interventions of Cabrol graft with aspiration thrombectomy and stenting have been previously described. We report a patient who successfully underwent percutaneous intervention on the graft by rheolytic thrombectomy followed by stenting in the setting of ST elevation myocardial infarction.

关键词： Cabrol Graft mechanical thrombectomy Manual thrombectomy

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Cerebral venous sinus thrombosis in pregnancy: A case report

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World Journal of Clinical Cases 2022年第1期10卷 309-315页

作者： Biao Zhou Shan-Shan Huang Can Huang Shu-Yun Liu Department of Neurology Dongguan Tungwah HospitalDongguan 523000Guangdong ProvinceChina Department of Intensive Care Unit The Seventh Affiliated HospitalSun Yat-Sen UniversityShenzhen 518000Guangdong ProvinceChina Department of Neurology Shenzhen Longhua District Central HospitalShenzhen 518000Guangdong ProvinceChina

BACKGROUND Cerebral venous thrombosis(CVT)is a rare but life-threatening disease in pregnant *** is the first-line therapy for CVT ***,some patients have poor outcomes despite ***,the endovascular treatment of CVT in pregnant women remains *** report a rare case of CVT in a pregnant woman who was successfully treated with two stent retriever *** SUMMARY The patient was a 29-year-old pregnant *** was first diagnosed with hyperemesis gravidarum due to severe nausea and vomiting for one *** the disease progressed,she developed acute left *** confirmed the diagnosis of superior sagittal sinus,right transverse sinus and sinus sigmoideus *** anticoagulant therapy was ineffective,she underwent *** the mechanical thrombectomy,her headache *** weeks later,the patient was completely *** a 3-mo follow-up,no relapse of symptoms was *** mechanical thrombectomy may be an effective alternative therapy for CVT in pregnant women if anticoagulation therapy fails.

关键词： Pregnancy Cerebral venous thrombosis Anticoagulation mechanical thrombectomy Case report

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Combined surgical and interventional treatment of tandem carotid artery and middle cerebral artery embolus: A case report

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World Journal of Clinical Cases 2020年第3期8卷 630-637页

作者： Meng Zhang Ji-Heng Hao Kai Lin Qing-Ke Cui Li-Yong Zhang Department of Neurosurgery Liaocheng Brain Hospital

BACKGROUND The 2018 American Heart Association/American Stroke Association guidelines for early management of acute ischemic stroke recommend the use of retrievable stents for mechanical thrombectomy in patients with acute internal carotid artery or middle cerebral artery M1 occlusion that can be treated within 6 h from *** cases of carotid artery with ipsilateral middle cerebral artery tandem embolization, the operation is more complicated and challenging. We here report a case of a tandem embolism, and the anatomy of the aortic arch was *** carotid artery incision and thrombectomy can not only prevent the escape of the carotid embolus but also save time during establishment of the thrombectomy *** SUMMARY The patient was a 70-year-old man. He was admitted to hospital due to sudden inability to speak and inability to move his right limb for 3 h. Imaging confirmed a diagnosis of a tandem embolism in the left carotid artery with left M1 *** artery incision thrombectomy combined with stent thrombectomy was performed. The operation was successful, and 24 h later the patient was conscious and mentally competent but had motor aphasia. His bilateral limb muscle strength level was 5, and his neurologic severity scores score was *** Carotid artery incision thrombectomy combined with stenting for carotid artery plus cerebral artery tandem embolization is clinically feasible. For patients with a complicated aortic arch and an extremely tortuous carotid artery, carotid artery incision can be chosen to establish the interventional path.

关键词： Carotid artery incision thrombectomy mechanical thrombectomy Carotid thrombosis Middle cerebral artery occlusion Tandem occlusion Case report

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