A Case of Acute Embolic Occlusion of the Common Carotid Artery in Which a Giant Thrombus Was Retrieved Using the Parallel Stent Retriever Technique

Tenyu Hino; Masayuki Sato; Mikito Hayakawa; Aiki Marushima; Yoshiro Ito; Taisuke Akimoto; Sho Okune; Takato Hiramine; Ryosuke Shintoku; Eiichi Ishikawa; Yuji Matsumaru

doi:10.5797/jnet.cr.2020-0164

CASE REPORTS

A Case of Acute Embolic Occlusion of the Common Carotid Artery in Which a Giant Thrombus Was Retrieved Using the Parallel Stent Retriever Technique

Tenyu Hino, Masayuki Sato, Mikito Hayakawa, Aiki Marushima, Yoshiro Ito, Taisuke Akimoto, Sho Okune, Takato Hiramine, Ryosuke Shintoku, Eiichi Ishikawa, Yuji Matsumaru

Author information

Tenyu Hino
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Masayuki Sato
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Mikito Hayakawa
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Aiki Marushima
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Yoshiro Ito
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Taisuke Akimoto
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Sho Okune
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Takato Hiramine
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Ryosuke Shintoku
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Eiichi Ishikawa
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Yuji Matsumaru
Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

Keywords: giant thrombus, embolic occlusion of the common carotid artery, endovascular thrombectomy, cardiogenic embolism

JOURNAL OPEN ACCESS

2022 Volume 16 Issue 2 Pages 87-92

DOI https://doi.org/10.5797/jnet.cr.2020-0164

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Abstract

Objective: We report a case of embolic occlusion of the common carotid artery (CCA) in which a giant thrombus was retrieved using the parallel stent retriever technique.

Case Presentation: An 84-year-old woman without anticoagulant therapy despite a history of cardioembolic stroke presented to our hospital because of left hemiparesis after developing sudden vision loss in her right eye. Emergency angiography revealed a giant thrombus in the right CCA. After arresting flow in the CCA using a balloon-guided catheter (BGC), we deployed two stent retrievers in parallel from the internal carotid artery to the CCA, and slowly retrieved them simultaneously under manual aspiration through the BGC. As a result, complete recanalization was achieved.

Conclusion: Thrombi causing acute embolic occlusion of the CCA are often too large to be completely retrieved using conventional thrombectomy techniques. The parallel stent retriever technique may be effective in such cases.

Corresponding author

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