Kim Seul Kee, Baek Byung Hyun, Heo Tae Wook, Yoon Woong
Department of Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.
Neurointervention. 2016 Mar;11(1):55-8. doi: 10.5469/neuroint.2016.11.1.55. Epub 2016 Mar 3.
Acute ischemic stroke due to embolic occlusion of the middle cerebral artery (MCA) in patients with chronic ipsilateral internal carotid artery (ICA) occlusion is quite rare. Several previous reports demonstrated that intra-arterial (IA) thrombolytic therapy or aspiration thrombectomy using the cross-circulation technique via an alternative collateral pathway is feasible in acute stroke patients with an unfavorable direct route to the occluded sites. However, stent-retriever embolectomy via the cross-circulation approach has not been reported in the literature. The present paper reports the first case of successful stent-retriever embolectomy for acute MCA occlusion via the patent posterior communicating artery (PComA) by using Trevo XP ProVue stent-retriever in a patient with acute MCA stroke and chronic occlusion at the origin site of the ipsilateral ICA.
慢性同侧颈内动脉（ICA）闭塞患者因大脑中动脉（MCA）栓塞性闭塞导致的急性缺血性卒中相当罕见。先前的几份报告表明，对于急性卒中患者，若直接到达闭塞部位的途径不佳，通过替代侧支循环途径采用动脉内（IA）溶栓治疗或使用交叉循环技术进行抽吸血栓切除术是可行的。然而，文献中尚未报道过通过交叉循环途径进行支架取栓术。本文报道了首例通过后交通动脉（PComA）途径成功使用Trevo XP ProVue支架取栓器对急性MCA闭塞进行支架取栓术的病例，该患者患有急性MCA卒中且同侧ICA起始部位慢性闭塞。
