Arterial vasospasm during mechanical thrombectomy for acute stroke.

OBJECTIVE AND IMPORTANCE

Mechanical maneuvers are being utilized more frequently to treat large artery occlusion responsible for acute ischemic stroke. Vasospasm due to vessel irritation during interventions may represent an etiology of poor recanalization in some patients.

CASE REPORTS

This report describes 2 patients who developed arterial vasospasm at the site of deployment of the L5 Merci retrieval device. The vasospasm was significant in nature and occlusive to one division of the middle cerebral artery. Both patients were treated with infusion of calcium channel antagonists with resolution of the narrowing.

CONCLUSIONS

Vasospasm after mechanical thrombectomy may represent a potential etiology for poor recanalization particularly if this is severe enough to cause complete occlusion. The use of pharmacological agents to treat suspected vasospasm should be considered during endovascular revascularization procedures for acute ischemic stroke, but care must be taken in monitoring decreases in blood pressure.