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AJNR - American Journal of Neuroradiology

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Transarterial Embolectomy in Acute Stroke

Gunnar Wikholm^a

^a From the Department of Interventional Neuroradiology, Sahlgrenska University Hospital, Göteborg, Sweden

View larger version (72K): [in a new window]   FIG 1. Diagnostic angiogram (left vertebral artery injection, anteroposterior projection of the basilar artery) shows the basilar tip embolus (arrow) occluding the left posterior cerebral artery, the left superior cerebellar artery, and the basilar tip perforators going to the thalamus.

View larger version (72K): [in a new window]   FIG 2. The snare (arrow) has been pushed out of the microcatheter just enough to open fully, and together with the microcatheter, it has been further pushed into the embolus. A minor buckling of the loop is seen.

View larger version (72K): [in a new window]   FIG 3. The snare has been partially withdrawn into the microcatheter, leaving a small eye outside the tip (bottom arrow) of the microcatheter. After this, the microcatheter with the snare is pulled back a few centimeters, and contrast material is injected. The angiogram shows the clot (top arrow) as a lucency in the contrast material hanging from the tip of the microcatheter. The now-open basilar tip is clearly seen with all of the branches filling (arrowhead).