Mechanical thrombectomy using an intracranial mechanical thrombectomy device for a brachial artery embolism during a mechanical thrombectomy for a cerebral infarction

Abstract

  An 80‒year‒old Japanese man developed consciousness disorder and right hemiplegia and was brought to our hospital. An examination by 3D‒CTA revealed left internal carotid artery occlusion. Intravenous recombinant tissue plasminogen activator (rt‒PA) therapy and mechanical thrombectomy were performed, and during the intracranial mechanical thrombectomy the patient’s left upper arm blood pressure could suddenly not be measured. Priority was given to the intracranial mechanical thrombectomy. The door‒to‒reperfusion time was 148 min, and the thrombolysis in cerebral infarction (TICI) grade of 2b was obtained. A mechanical thrombectomy was performed using an intracranial mechanical thrombectomy device for a left brachial artery embolism. The onset‒to‒reperfusion time of 103 min was necessary to reopen the artery. This patient’s case emphasizes that brain artery occlusion and acute limb artery occlusion can be combined, and stroke care with limb artery occlusion in mind is important. Brain tissue is vulnerable to acute limb artery occlusion combined with acute limb artery occlusion, and thus immediate treatment for limb artery occlusion should be performed after a thrombectomy for the brain artery. An intracranial mechanical thrombectomy device may be useful for limb artery occlusion, and its use should be considered in emergency situations.