A case of left middle cerebral artery embolism due to Takayasu’s arteritis in the common carotid artery

Abstract

Objective: We report a rare case of left middle cerebral artery embolism due to Takayasu’s arteritis in the common carotid artery. Case presentation: A 24-year-old female presented with motor aphasia and right hemiparesis. MRI showed early ischemic changes in the left insular cortex. Cervical MRA showed occlusion of left common carotid artery and left middle cerebral artery (MCA). Because the patient was ineligible for intravenous recombinant tissue plasminogen activator, we chose endovascular therapy for recanalization. Aorta angiogram demonstrated typical findings of Takayasu’s arteritis and occlusion extending from the distal M1 to M2 segment of the MCA. Therefore, we performed thrombolysis passing catheter through the Pcom and thrombectomy using a Penumbra^® system. The occluded MCA was successfully recanalized and good clinical outcome was obtained. Conclusion: We considered that the left MCA occlusion was caused by artery-to-artery embolism derived from Takayasu’s arteritis. This is the first report of thrombectomy using a Penumbra^® system of the thrombus due to Takayasu’s arteritis.