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Intraarterial Suction Thrombectomy in Acute Stroke

Helmi L. Lutsepa, Wayne M. Clarkb, Gary M. Nesbitb, Todd A. Kuetherb and Stan L. Barnwellb

a the Oregon Stroke Center, Oregon Health Sciences University, Portland
b the Dotter Interventional Institute, Oregon Health Sciences University, Portland



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  		FIG 1. Case 1. A 67-year-old man presented with resolving left hemiparesis.

A, Baseline right lateral common carotid artery (CCA) angiogram shows near-occlusion of the right ICA with a string sign of slow flow into the proximal ICA.

B, After predilation of the proximal ICA stenosis, this baseline right ICA angiogram reveals the presence of extensive thrombus.

C, Baseline left CCA angiogram reveals some right ACA cross-filling but no right MCA filling.

D, Postprocedural right lateral CCA angiogram shows less than 20% residual ICA stenosis. A Wallstent in the ICA is visible at the carotid bifurcation.

E, Although the right MCA has a persistent mid-M1 occlusion, the postprocedural right CCA angiogram shows good distal filling of the MCA branches via pial collaterals from the ACA.



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  		FIG 2. Case 2. A 72-year-old man had global aphasia and right hemiparesis.

A, Baseline left lateral CCA angiogram shows complete occlusion of the cervical ICA. Flow through a 50% stenosis of the external carotid artery remains visible.

B, Postprocedural left lateral CCA angiogram demonstrates essentially complete resolution of the ICA occlusion. The Wallstent placed in the left ICA is visible at the carotid bifurcation.



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  		FIG 3. Case 3. A 49-year-old man with atrial fibrillation and a poor cardiac ejection fraction presented with left hemiparesis and right gaze preference

A, Baseline right lateral CCA angiogram shows complete occlusion of the right ICA.

B, Postprocedural right lateral CCA angiogram shows restored flow within the right ICA. A long segment of vessel narrowing is seen within the cervical ICA.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X