Stent Retriever Angioplasty for Intracranial Atherosclerotic Disease-Related Medium Vessel Occlusion: A Case Report and Literature Review

Objective: Stent retriever (SR) angioplasty is an adjunctive technique for acute large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO). Prolonged SR deployment maintains blood flow distal to the atherosclerotic lesion until the antiplatelet agent has exerted...

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Bibliographic Details
Published in:Journal of Neuroendovascular Therapy 2024, Vol.18(10), pp.273-277
Main Authors: Inui, Ryoma, Abe, Soichiro, Ishiyama, Hiroyuki, Tsutsui, Takeyoshi, Yamamoto, Akimasa, Shiomi, Yuma, Yoshimoto, Takeshi, Imamura, Hirotoshi, Kataoka, Hiroharu, Ihara, Masafumi
Format: Article
Language:English
Subjects:
Case Report
intracranial atherosclerotic disease
medium vessel occlusion
stent retriever angioplasty
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Summary:Objective: Stent retriever (SR) angioplasty is an adjunctive technique for acute large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO). Prolonged SR deployment maintains blood flow distal to the atherosclerotic lesion until the antiplatelet agent has exerted its effect. Although SR angioplasty for ICAD-LVO has been reported, few reports are available on SR angioplasty for medium vessel occlusion stroke due to underlying ICAD (ICAD-MeVO). Here, we describe a case of SR angioplasty for acute occlusion of the left M2 segment of the middle cerebral artery (MCA) due to underlying ICAD.Case Presentation: A 79-year-old man with a history of left MCA M2 segment stenosis presented with motor aphasia and dysarthria. Diffusion-weighted MRI showed no high-signal intensity areas, and MRA showed occlusion of the left MCA M2 segment. The patient was diagnosed with ICAD-MeVO. After performing an MRI, the patient’s symptoms progressed to total aphasia. SR angioplasty was performed for the occlusion of the left M2 segment of the MCA. Diffusion-weighted MRI the day after the procedure showed a small area of high-signal intensity exclusively in the left putamen, while MRA confirmed recanalization of the left MCA M2 segment. Aphasia improved after the procedure. No re-occlusion was observed for 90 days, and the modified Rankin Scale score at 90 days was 2.Conclusion: SR angioplasty appears to be a safe option for managing MCA M2 segment occlusion.
ISSN:1882-4072
2186-2494
DOI:10.5797/jnet.cr.2024-0053