A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

Takanari Okamoto; Keisuke Imai; Masashi Hamanaka; Hidekazu Yamazaki; Masahiro Itsukage; Kazuma Tsuto; Atsushi Yamamoto; Tetsuya Ioku; Takuma Nakamura; Masayoshi Kimura; Kimitoshi Kitani; Kunihiko Umezawa

doi:10.5797/jnet.cr.2016-0123

Case Reports

A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

Takanari Okamoto, Keisuke Imai, Masashi Hamanaka, Hidekazu Yamazaki, Masahiro Itsukage, Kazuma Tsuto, Atsushi Yamamoto, Tetsuya Ioku, Takuma Nakamura, Masayoshi Kimura, Kimitoshi Kitani, Kunihiko Umezawa

Author information

Takanari Okamoto
Department of Neurosurgery, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Keisuke Imai
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Masashi Hamanaka
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Hidekazu Yamazaki
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Masahiro Itsukage
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Kazuma Tsuto
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Atsushi Yamamoto
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Tetsuya Ioku
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Takuma Nakamura
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Masayoshi Kimura
Department of Cardiology, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Kimitoshi Kitani
Department of Cardiovascular Surgery, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan
Kunihiko Umezawa
Department of Neurosurgery, Kyoto First Red Cross Hospital, Kyoto, Kyoto, Japan

Keywords: cardiogenic embolism, embolic occlusion of brachiocephalic artery, endovascular thrombectomy, balloon-guide catheter, fogarty catheter

JOURNAL OPEN ACCESS

2017 Volume 11 Issue 6 Pages 315-321

DOI https://doi.org/10.5797/jnet.cr.2016-0123

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Abstract

Objective: Endovascular treatment of a patient with acute embolism of the brachiocephalic artery (BCA) is reported.

Case Presentations: A 70-year-old woman presenting with weakness of the right upper extremity was transferred to our hospital due to acute embolism of the BCA. After the right brachial artery was secured by direct cardiovascular surgery, a balloon guidewire was inserted through the femoral artery and advanced near the thrombus in the BCA, and the balloon at its tip was inflated in the right internal carotid artery. Immediately after this, the thrombus in the BCA migrated to the right common carotid artery and right subclavian artery. The two vessels could be recanalized by endovascular treatment via a guide catheter and via the right brachial artery, respectively.

Conclusion: In endovascular treatment for acute embolization of the BCA, the methods for thrombus retrieval and distal protection have not been established, and the concurrent direct surgery and cooperation by a cardiologist are indispensable.

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