Y-double stent-retriever thrombectomy for terminal acute internal carotid artery T occlusion

Abstract

Objective To observe the feasibility and effectiveness of Y-double stent-retriever thrombectomy for terminal acute internal carotid artery T occlusion. Methods From September 2013 to April 2015, 7 patients with cardioembolism caused distal end occlusion of acute internal carotid artery were treated with double-Y stent-retriever thrombectomy at the Center of Cerebrovascular Diseases, Shanghai Changhai Hospital, the Second Military Medical University. All patients with middle cerebral artery occlusion were treated with the Revive stents. Results After thrombectomy, 6 patients(6/7)achieved recanalization successfully. The modified Thrombolysis in Cerebral Infarction(mTICI)grade achieved grade 2 b-3, 5 of them were recanalized completely(mTICI grade 3); 1 was grade 2a. The time from puncture to recanalization was 38-97 min(mean 57.1±21.6 min). One patient had a new thrombosis, 1 had intracranial space-occupying hematoma, and 1 died of pulmonary infection after procedure. No new stroke, transient ischemic attack, death event, and re-occlusion occurred during the 3-month follow-up period. Conclusion The use of double stent-retriever thrombectomy technique for the treatment of terminal acute internal carotid artery T occlusion is safe and feasible, and the vascular recanalization rate is higher. Key words: Internal carotid artery; Arterial occlusive diseases; Endovascular procedures; Stents; Thrombectomy