2023 Volume 26 Issue 1 Pages 40-45
A 63-year-old man with a medical history of arterial fibrillation was transferred to our emergency department secondary to right hemiparesis and dysarthria. On admission, the patient was observed to have non-palpable left radial artery pulse and left dorsalis pedis artery pulse. Computed tomography angiography revealed top of the basilar artery occlusion (BAO) caused by cardiogenic embolism, but no aortic dissection. At that time, left brachial and ulnar arteries embolization was concluded. Mechanical thrombectomy for BAO was successfully achieved with good recanalization. Subsequently, diagnostic angiography was performed for left upper and lower extremities artery occlusion. Thereafter, mechanical thrombectomy was successfully achieved. Although diagnosis and treatment delay for acute extremity artery occlusion may lead to a poor outcome, assessment by physicians is sometimes difficult in primary stroke care. It is important to require vascular examination by palpation of arterial pulses of the extremities for a differential diagnosis. If a pulse is non-palpable, clinical physicians should recognize that non-palpable arteries in extremities is a reliable indication for sudden-onset extremities ischemia in patients with embolic stroke.
