Roche Adam D, Murphy Blathnaid, Adams Niamh, Sheahan Richard, Brennan Paul, Looby Seamus
Department of Radiology, Division of Neuroradiology, Beaumont Hospital, Dublin, Ireland.
Department of Radiology, Division of Neuroradiology, Beaumont Hospital, Dublin, Ireland.
J Stroke Cerebrovasc Dis. 2017 Nov;26(11):e211-e213. doi: 10.1016/j.jstrokecerebrovasdis.2017.07.017. Epub 2017 Aug 23.
Coarctation of the aorta is a condition that typically presents in childhood as a congenital malformation. This report describes a case of acute right middle cerebral artery ischemic stroke, which occurred in a patient with aortic coarctation that remained undiagnosed until her eighth decade. Complex anatomical variant presented a significant technical challenge in establishing endovascular access for mechanical thrombectomy using standard femoral, brachial, or radial artery approaches. Direct right common carotid puncture was performed successfully with subsequent reperfusion and full neurological recovery. Direct carotid artery puncture represents an alternative to standard transfemoral access in the event of stroke in a patient with difficult anatomy.
主动脉缩窄是一种通常在儿童期表现为先天性畸形的病症。本报告描述了一例急性右大脑中动脉缺血性卒中病例，该病例发生在一名主动脉缩窄患者身上，直到她八十多岁时才被诊断出来。复杂的解剖变异在使用标准股动脉、肱动脉或桡动脉途径建立机械取栓的血管内通路时带来了重大技术挑战。成功进行了直接右颈总动脉穿刺，随后实现了再灌注且神经功能完全恢复。对于解剖结构复杂的患者发生卒中的情况，直接颈动脉穿刺是标准经股动脉入路的一种替代方法。
