Mechanical Thrombectomy Combined Aspiration Catheter with Stent Retriever without Guiding Catheter via the Transbrachial Approach for Basilar Artery Occlusion

Abstract

Objective: We report a mechanical thrombectomy strategy combined aspiration catheter with stent retriever without guiding catheter (GC) via transbrachial approach for a basilar artery (BA) occlusion.

Case Presentations: A 95-year-old female was transferred to our hospital because of impaired consciousness. BA occlusion was revealed on MRA. Because of type 3 arch on chest CT image, catheter access through transfemoral approach was thought to be difficult. A sheath was inserted into the right brachial artery. We did not use a GC to maintain antegrade blood flow to BA. An aspiration catheter was placed in the right vertebral artery. After a stent retriever was deployed across a clot, the aspiration catheter was advanced to the face of clot. We then removed the stent retriever and the aspiration catheter with pump-aspiration as a single unit into the sheath and complete recanalization was obtained.

Conclusion: The transbrachial approach mechanical thrombectomy is a useful option in patients who thought to be difficult to access through the transfemoral approach.