A Case of Delayed Symptomatic Middle Cerebral Artery Stenosis Following Mechanical Thrombectomy

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Objective: A novel mechanical thrombectomy device for acute ischemic stroke has provided a favorable outcome. However, it is not well known that delayed stenotic change of the affected arterial wall can be caused by device scratching.Case Presentations: A 73-year-old male presented with a symptomatic left middle cerebral artery (MCA) occlusion. The patient was recovered without any sequelae after stent-using mechanical thrombectomy. During follow-up in the outpatient department, magnetic resonance angiography and imaging revealed a progressive diffuse severe MCA stenosis and leukoencephalopathy. A hundred and eight days after the stent assisted procedure, the patient received percutaneous transluminal balloon-angioplasty, because of the resistance to any medical treatment and minor ischemic symptom.Conclusion: The authors state that close observation of both vascular lumen and wall is mandatory after mechanical thrombectomy and postoperative symptomatic stenosis may occur as in this case.