Posterior Cerebral Artery Occlusion treated with Thrombectomy via the Posterior Communicating Artery: A Case Report

Abstract

  Few clinical reports in the available literature have described thrombectomy for occlusion of a small cerebral artery.

  Case : A 61-year-old woman presented with impaired consciousness, aphasia and right-sided hemiparesis. The last known well to arrival time was 4 hours. CT and MRI revealed acute ischemia of the left thalamus and left occipital lobe and subacute ischemia of the right occipital lobe. MR angiography revealed occlusion of the left posterior cerebral artery. DSA revealed that the left posterior cerebral artery originated from the left posterior communicating artery, and we detected a small aneurysm in the left internal carotid artery-left posterior communicating artery. We performed thrombectomy via the left posterior communicating artery using the Penumbra system^® to avoid aneurysmal injury by a stent retriever. The Penumbra 3MAX^TM was placed at the site of occlusion in the left posterior cerebral artery and aspiration was performed leading to cerebral infarction (TICI) grade 3 recanalization of the left posterior cerebral artery. The patient's symptoms improved, and she was discharged with a modified Rankin Scale score of 2.