Mechanical Thrombectomy for ICA Top Occlusion with Twig-Like MCA: A Case Report

Abstract

Objective: We report a case of hemorrhagic complication after mechanical thrombectomy (MT) for internal carotid artery (ICA) occlusion with twig-like middle cerebral artery (MCA).

Case Presentation: A 75-year-old man was admitted to our hospital with ICA occlusion. Recanalization was achieved by a direct aspiration first pass technique (ADAPT). The peripheral MCA was twig-like, but operators thought that a thrombus remained in the MCA first segment. The procedure was continued and suspended with perforation of the microguidewire.

Conclusion: When performing MT for large vessel occlusion (LVO) with twig-like MCA, it is difficult to proceed a device to the periphery and there is a risk of hemorrhage.