Document Detail


Arterial ReOcclusion and Persistent Distal Occlusion after Thrombus Aspiration.
MedLine Citation:
PMID:  20572904     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Early reocclusion of intracranial arteries can lead to poor clinical outcome. We report reocclusion detection after endovascular clot aspiration, followed by administration of GPIIb-IIIa antagonist under continuous ultrasound monitoring.
CASE DESCRIPTION: A 73-year-old man developed the right middle cerebral artery (MCA) occlusion with NIHSS 17 points, 6 days after aortic valve replacement. Recanalization was achieved with Penumbra™ system and reocclusion was detected with transcranial Doppler (TCD) 30 minutes postcompletion of intra-arterial procedure. Proximal recanalization was achieved with the second thrombus aspiration while M2 MCA occlusion persisted beyond the reach of the device. Intravenous abciximab was administered under continuous TCD monitoring. Recanalization with Thrombolysis in Brain Ischemia (TIBI) flow grade 4 was observed at 60 minutes postintervention accompanied with clinical recovery to NIHSS 3 points. Abciximab was given for 12 hours with no hemorrhagic transformation on repeat CT scan. Patient was discharged home with mild left pronator drift and facial droop, and his modified ranking score was 1 at 6-week follow-up visit.
CONCLUSIONS: Early arterial reocclusion can occur after successful thrombus aspiration while GPIIb-IIIa antagonist administration may lead to subsequent recanalization of persisting distal occlusions not amenable to mechanical removal.
Authors:
Limin Zhao; Marta Rubiera; Mark R Harrigan; Andrei V Alexandrov
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Publication Detail:
Type:  Journal Article     Date:  2010-06-21
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  22     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  92-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 by the American Society of Neuroimaging.
Affiliation:
Comprehensive Stroke Center University of Alabama Hospital, Birmingham, AL (LZ, MR, AVA); and Endovascular Neurosurgery, University of Alabama Hospital, Birmingham, AL (MRH).
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