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Clot Removal Therapy by Aspiration and Extraction for Acute Embolic Carotid Occlusion

K. Imaia, T. Moria, H. Izumotoa, N. Takabatakea, T. Kuniedaa, H. Shimizub and M. Watanabec

a Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa, Japan
b Department of Pathology, Shonan Kamakura General Hospital, Kanagawa, Japan
c Department of Neurology, Kumamoto University School of Medicine, Kumamoto, Japan


Figure 1
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  		Fig 1. Photograph of the basket-type microsnare (Soutenir, 5 mm) after deployment through the 2.3F microcatheter. The fully extended basket of the microsnare is 5 mm in diameter when the microsnare is protruded completely from the microcatheter (A) and is closed appropriately when partially withdrawn into the microcatheter (B).


Figure 2
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  		Fig 2. Anteroposterior left carotid angiograms in case 7. A, Angiogram obtained before the procedure showing total occlusion of the left internal carotid artery (ICA). B, Angiogram obtained during the procedure demonstrating the microsnare (In-Time, arrow) and proximal ICA blockade by inflation of the coaxial balloon (arrowheads). C and D, Angiograms obtained immediately after the procedure showing complete recanalization of the ICA, without distal embolization. Some branches of the MCA do not fill, and filling of the MCA is slow compared with that of the anterior cerebral artery (D).


Figure 3
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  		Fig 3. Macroscopic photograph showing the 4 clots retrieved in case 7. The extent of the longest clot is >7 cm.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X