Successful Thrombectomy in Acute Terminal Internal Carotid Occlusion Using a Basket Type Microsnare in Conjunction with Temporary Proximal Occlusion: A Case Report
Keisuke Imaia,
Takahisa Moria,
Hajime Izumotoa and
Masaki Watanabeb
a Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura, Japan
b Department of Neurology, Kumamoto University School of Medicine, Kumamoto, Japan
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FIG 1. Anteroposterior right carotid angiogram.
A, Angiogram before the procedure showing total occlusion of the terminal internal carotid artery (arrow).
B, Angiogram during the procedure demonstrating the microsnare basket (arrowheads) at the level of the clot, which is protruding from the microcatheter tip (arrow).
C, Angiogram obtained after removal of the microsnare with the microcatheter and deflation of the coaxial proximal balloon showing that the clot has been removed, and normal flow has been reestablished in the previously occluded vessel without distal branch occlusion.
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FIG 2. A, Anteroposterior right carotid angiogram showing proximal ICA blockade by inflation of the coaxial balloon (arrowheads) on the guiding catheter.
B and C, The microsnare is visualized after being deployed through the 2.3F microcatheter. The fully extended stainless basket of the microsnare is 5 mm in diameter, when the microsnare is protruded completely from the microcatheter (B) and is closed appropriately when it is partially withdrawn into the microcatheter (C). The scale is in centimeters.
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FIG 3. The extracted clot is >10 mm in length. The scale is in centimeters.
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