Successful Thrombectomy Using Sofia (6F) PLUS Catheter in Acute Stroke Patient with Coincident Proximal Unruptured Aneurysm.

Abstract

BACKGROUND:

Little literature is available on mechanical thrombus aspiration in acute ischemic stroke with coincident ipsilateral unruptured aneurysm, especially with aneurysm proximal to the occlusion site. In this report, we describe a case of ischemic stroke in a patient with acute occlusion of M1 segment of the middle cerebral artery with coincident ipsilateral internal carotid artery-posterior communicating artery aneurysm who was successfully treated by mechanical clot retrieval using the Sofia (6F) PLUS technique (MicroVention Terumo, Tustin, California, USA).

CASE DESCRIPTION:

A 52-year-old woman presented at our hospital 6 hours after sudden onset of dysarthria and right limb hemiplegia on waking up in the morning. She was managed using a direct aspiration first pass technique for distal middle cerebral artery mechanical aspiration using the Sofia (6F) PLUS catheter. The thrombus was manually aspirated in 2 minutes, and Thrombolysis in Cerebral Infarction scale 3 flow was restored. Next, LVIS (MicroVention Terumo, Tustin, California, USA) stent-assisted coiling of the aneurysm of the posterior communicating segment of the left internal carotid artery was immediately undertaken. The National Institutes of Health Stroke Scale score was 4 at day 1 and 0 at day 7 postoperatively. No device-related or catheter-related complications occurred.

CONCLUSIONS:

Ischemic stroke patients with coincident aneurysm are at increased risk of aneurysmal rupture and should be managed with tailored endovascular strategies. Our case shows that a direct aspiration first pass technique using the Sofia (6F) PLUS catheter provides a safe, effective approach for thrombus aspiration in stroke patients.

• Authors: Hui Li, Jian-Feng Liu, Cong-Hui Li, Ji-Wei Wang, Yang-Yang Tian
• Journal: World neurosurgery (World Neurosurg) Vol. 132 Pg. 245-250 (Dec 2019) ISSN: 1878-8769 [Electronic] United States
• PMID: 31476466 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Cerebral Angiography
• Computed Tomography Angiography
• Endovascular Procedures (methods)
• Female
• Humans
• Incidental Findings
• Intracranial Aneurysm (complications, diagnostic imaging, surgery)
• Middle Aged
• Middle Cerebral Artery (surgery)
• Stroke (complications, diagnostic imaging, surgery)
• Thrombectomy (methods)
• Treatment Outcome