Yoshie Tomohide, Suzuki Yu, Tatsuno Kentaro, Ueda Toshihiro
Department of Neurology and Endovascular Treatment Service, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan.
NMC Case Rep J. 2021 Jul 1;8(1):355-358. doi: 10.2176/nmccrj.cr.2020-0311. eCollection 2021.
Situs inversus is a rare congenital anomaly which has the mirror image of systemic organs and vessels from their normal position. We report a case of endovascular thrombectomy for acute middle cerebral artery (MCA) M1 occlusion in a patient with complete situs inversus. A right-handed man in his 70s presented to our hospital with loss of consciousness, right-sided hemiplegia, and total aphasia. Endovascular thrombectomy was undertaken for left M1 occlusion. Guide catheter advanced through right aortic arch and injection showed innominate artery was on the left side. Left common carotid artery arose from left innominate artery. Using aspiration catheter and stent retriever, successful recanalization was achieved after three passes. For treatment of acute stroke with large vessel occlusion in patients with situs inversus, understanding anatomy and clinical features of situs inversus is important.
内脏反位是一种罕见的先天性异常，其全身器官和血管的位置与正常位置呈镜像关系。我们报告一例完全性内脏反位患者急性大脑中动脉（MCA）M1段闭塞的血管内血栓切除术病例。一名70多岁的右利手男性因意识丧失、右侧偏瘫和完全性失语入住我院。对左侧M1段闭塞进行了血管内血栓切除术。引导导管经右主动脉弓推进，造影显示无名动脉在左侧。左颈总动脉发自左无名动脉。使用抽吸导管和支架取栓器，经过三次操作成功实现再通。对于内脏反位患者的急性大血管闭塞性卒中治疗，了解内脏反位的解剖结构和临床特征很重要。
