Kuwahara Kiyonori, Nakahara Ichiro, Matsumoto Shoji, Suyama Yoshio, Morioka Jun, Hasebe Akiko, Tanabe Jun, Watanabe Sadayoshi, Suyama Kenichiro, Hirose Yuichi
Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Radiol Case Rep. 2024 Feb 13;19(5):1692-1696. doi: 10.1016/j.radcr.2024.01.071. eCollection 2024 May.
It is impossible to predict underlying anomalies in acute large vessel occlusion and it could be a problem when performing mechanical thrombectomy (MT). We report a case of MT for occlusion of the fenestrated middle cerebral artery (MCA) M1 segment. A 49-year-old woman presented to our hospital with dysarthria and left hemiparesis. Acute ischemic stroke due to right occluded MCA was diagnosed. During performing emergent MT, a part of the M1 segment was revealed to be slit-shaped by digital subtraction angiography, suggesting a fenestrated MCA. The aspiration catheter could not be advanced through the narrow limb of the fenestration, and the distal thrombus was retrieved using a stent retriever, additionally. Postoperatively, the patient's symptoms improved without complications. When occlusion of the fenestrated MCA is suspected, it is necessary to consider converting the strategy from an aspiration catheter alone to the combined use of a stent retriever.
急性大血管闭塞时，很难预测潜在的血管异常，而这在进行机械取栓（MT）时可能会成为一个问题。我们报告了一例因开窗型大脑中动脉（MCA）M1段闭塞而行MT的病例。一名49岁女性因构音障碍和左侧偏瘫入住我院。诊断为右侧MCA闭塞所致的急性缺血性卒中。在进行急诊MT时，数字减影血管造影显示M1段的一部分呈裂隙状，提示为开窗型MCA。抽吸导管无法通过开窗的狭窄分支推进，另外还使用了支架取栓器取出远端血栓。术后，患者症状改善，无并发症。当怀疑为开窗型MCA闭塞时，有必要考虑将策略从单纯使用抽吸导管转变为联合使用支架取栓器。
