2018 年 12 巻 8 号 p. 386-392
Objective: We report a patient who underwent thrombectomy for acute bilateral internal carotid artery occlusion (ICAO).
Case Presentation: A 76-year-old female presented consciousness disturbance. Although warfarin had been administered after prosthetic replacement, it was discontinued due to gastrointestinal hemorrhage. MRI showed bilateral ICAO and right-dominant ischemic changes involving the bilateral hemispheres. Radiological findings indicated acute occlusion of the right internal carotid artery (ICA), and chronic occlusion of the left ICA was primarily considered; however, revascularization was conducted with considering the possibility of bilateral occlusion. Thrombectomy was performed and recanalization of the bilateral ICAs was achieved. However, ischemia progressed, leading to extensive cerebral infarction.
Conclusion: Thrombectomy for bilateral ICAO was performed although the outcome was unfavorable. Acute bilateral ICAO contains poor prognosis although it is indispensable to appropriately diagnose, evaluate, and select therapeutic strategy. A proper management for bilateral ICAO awaits further investigation.