Mechanical Thrombectomy for Basilar Artery Occlusion with a Type 1 Persistent Proatlantal Artery: A Case Report and Literature Review
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- Ito Shohei
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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- Asai Takumi
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan
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- Kimata Masayuki
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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- Ohno Masasuke
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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- Suzaki Noriyuki
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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- Kajita Yasukazu
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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- Takahashi Tatsuo
- Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
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<p>Objective: Persistent proatlantal artery (PPA) is a primitive carotid-vertebrobasilar anastomosis (CVA); acute ischemic stroke due to basilar artery (BA) occlusion via a PPA is extremely rare.</p><p>Case Presentation: An 84-year-old female developed disturbance of consciousness (Glasgow Coma Scale E2V1M5) and quadriparesis with a National Institutes of Health Stroke Scale score of 35. Head CT revealed early ischemic changes in the right temporal lobe, and a hyperdense vessel sign in the BA. Cerebral angiography showed that the left vertebral artery (VA) did not originate from the left subclavian artery or aortic arch. A left common carotid artery angiogram showed the presence of the left PPA originating from the left external carotid artery. Mechanical thrombectomy (MT) with contact aspiration using a Penumbra 5MAX ACE 60 aspiration catheter was performed, and successful recanalization was achieved after clot retrieval in the first attempt (thrombolysis in cerebral infarction scale 2b). MRI performed the following day, however, revealed a newly developed large hemorrhagic infarction in the pons, with no improvement in her symptoms (modified Rankin Scale score of 5 at 90 days).</p><p>Conclusion: Although MT achieved successful recanalization of the BA via the PPA, her clinical symptoms did not improve, probably because of poor collateral circulation or the long length of the occlusion. In patients with acute vertebro-BA occlusion, if the VA does not originate from the subclavian artery or aortic arch, the presence of a primitive CVA should be considered.</p>
収録刊行物
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- 脳神経血管内治療
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脳神経血管内治療 17 (7), 139-144, 2023
特定非営利活動法人 日本脳神経血管内治療学会
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詳細情報 詳細情報について
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- CRID
- 1390578304519139200
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- NII書誌ID
- AA1229439X
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- ISSN
- 21862494
- 18824072
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- NDL書誌ID
- 033068241
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
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- 抄録ライセンスフラグ
- 使用不可