Mechanical Thrombectomy for Occluded Internal Carotid Artery with Unruptured Cerebral Aneurysm at the Posterior Communicating Artery Bifurcation and Anterior Choroidal Artery Bifurcation: A Case Report

Abstract

Objective: We report a case of mechanical thrombectomy for acute occlusion of the intracranial internal carotid artery with two unruptured cerebral aneurysms.

Case Presentation: A 74-year-old woman developed dysarthria and left hemiparesis at wake-up, last seen normal 9 hours ago. She had a score of 20 points on the National Institutes of Health Stroke Scale (NIHSS). Three-dimensional reconstruction of the cerebral angiogram revealed a right internal carotid artery occlusion with right internal carotid-posterior communicating artery aneurysm. She was treated using a direct aspiration first pass technique (ADAPT), resulting in thrombolysis in cerebral infarction (TICI) grade 3. Postoperatively, the patient was transferred to a recovery hospital one month after mechanical thrombectomy due to residual left hemiparesis.

Conclusion: Appropriate treatment strategy is necessary for revascularization of patients with cerebral aneurysm in the occluded vessel.