Objectives: This report documents initial experiences with balloon catheter disruption (BCD) of a thrombus for an unrecanalized intracranial artery, even after intravenous recombinant tissue plasminogen activator (IV-rtPA). Methods: From August 2006 to February 2008, 12 patients with acute major vessel occlusion underwent IV-rtPA, and recanalization of the affected artery was not obtained in 8 patients. Seven of these 8 patients underwent BCD immediately after the completion of continuous rtPA infusion without the addition of thrombolytic agents. Results: Of the 7 patients that underwent BCD, 4 patients (57%) showed complete or partial recanalization and relatively favorable clinical outcomes were obtained compared to patients without recanalization. No technical complications were observed in these patients. Conclusions: Although the number of patients was limited, intra-arterial rescue therapy, BCD, may be effective for patients with an unrecanalized intracranial artery after IV-rtPA therapy.
Purpose: A case of multiple brain infarction caused by embolism of a chondroma in the left vertebral artery is reported. Case presentation: A 38-year-old woman was admitted for cerebral infarction. On angiography, a round filling defect was observed in the V2 segment of the patent left vertebral artery, thought to be a floating embolus. The patient was successfully treated with embolectomy by means of endovascular procedures immediately after angiography. Histopathologic evaluation indicated the embolus to be a piece of chondroma. Conclusion: Cerebral embolism from tumor, especially chondroma, is extraordinarily rare. The source of the embolism in this patient is thought to most likely be the heart.