Abstract
There are few case reports of thrombectomy via the arterial circle of Willis. We report a case of acute left middle cerebral artery occlusion with chronic left cervical internal carotid artery occlusion, in which thrombus retrieval therapy was performed via the anterior communicating artery and effective recanalization was achieved, with literature review. The patient was an 83-year-old woman. She had been suffering from chronic left internal carotid occlusion for some time and was brought to our hospital with sudden loss of consciousness, aphasia, and quadriplegia. Neuroradiological imaging led to the diagnosis of acute cerebral infarction due to bilateral middle cerebral artery occlusion, and emergency thrombectomy was performed within 5 hours of onset. A guiding catheter was placed in the right internal carotid artery of the neck, and decisive thrombectomy was performed using a stent retriever via the anterior communicating artery, resulting in effective recanalization of the left middle cerebral artery occlusion. Subsequently, thrombectomy was also performed for the right middle cerebral artery occlusion, and effective recanalization was obtained (onset to perfusion times: 6 hours and 37 minutes). Postoperatively, the patient had a poor outcome due to the presence of bilateral scattered cerebral infarction.
