Endovascular Mechanical Thrombectomy of an Occluded Superior Division Branch of the Left MCA for Acute Cardioembolic Stroke

Journal Article · Sun Jun 15 00:00:00 EDT 2003 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-003-2719-5· OSTI ID:21088385

Meyers, P M ^[1]; Yavagal, D R; Harel, N Y; Elkind, M S. V.; Mohr, J P ^[2]; Pile-Spellman, J ^[3]

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1. New York Presbyterian Hospital, College of Physicians and Surgeons of Columbia University, 177 Fort Washington Avenue, New York, New York 10032, Department ofInterventional Neuroradiology, Milstein Hospital Building, 8 Knuckle South (United States)
2. New York Presbyterian Hospital, College of Physicians and Surgeons of Columbia University, Box 131, 710 West 168th Street, New York, NY 10032, Neurological Institute, Doris and Stanley Tananbaum Stroke Center (United States)
3. New York Presbyterian Hospital, College of Physicians and Surgeons of Columbia University, 177 Fort Washington Avenue, New York, New York 10032, Department of Interventional Neuroradiology, Milstein Hospital Building, 8 Knuckle South (United States)

Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhageas time passes from stroke onset. We report successful mechanicalthrombectomy from a distal branch of the middle cerebral artery (MCA)using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due toa recent myocardial infarction. Intra-arterial administration of 4 mgrt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours,symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents.

• OSTI ID: 21088385
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 26; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CEREBRAL ARTERIES
EXTRACTION
HEALTH HAZARDS
MYOCARDIAL INFARCTION
SURGERY
VASCULAR DISEASES