Reocclusion of Recanalized Arteries during Intra-arterial Thrombolysis for Acute Ischemic Stroke
Adnan I. Qureshia,b,
Amir M. Siddiquib,
Stanley H. Kima,
Ricardo A. Hanela,
Andrew R. Xavierb,
Jawad F. Kirmania,
M. Fareed K. Suria,
Alan S. Boulosa and
L. Nelson Hopkinsa
a Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
b Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, Newark, NJ
c Division of Neurosurgery, Albany Medical College, Albany, NY
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FIG 1. Patient 2.
A, Cerebral angiogram shows occlusion of the right middle cerebral artery (M1 segment, grade 3A).
B, Partial recanalization of the M1 and M2 segments is observed after the administration of 2 U of reteplase.
C, Reocclusion is observed involving the M2 segment of the middle cerebral artery.
D, Recanalization is observed in the middle cerebral artery after administration of an additional 1 U of reteplase.
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FIG 2. Patient 4.
A, Cerebral angiogram shows occlusion of the right internal carotid artery (supraclinoid segment, grade 5).
B, Recanalization is observed after administration of thrombolytics and snare maneuver. The filling defect at the junction of the internal carotid and middle cerebral arteries (arrow) indicates the presence of residual thrombus.
C, Reocclusion of the supraclinoid segment of the internal carotid artery is observed after administration of further thrombolytics.
D, Recanalization of the middle cerebral artery after stent placement in the M1 segment of the middle cerebral artery.
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