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AJNR - American Journal of Neuroradiology

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Emergent Combined Intracranial Thrombolysis and Carotid Stenting in the Hyperacute Management of Stroke Patients with Severe Cervical Carotid Stenosis

H. Wang^a,b, D. Wang^a, K. Fraser^a, J. Swischuk^a and P. Elwood^a

^a Departments of Neurosurgery, Radiology, and Neurology, Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Peoria, Ill
^b Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass

View larger version (142K): [in this window] [in a new window]   Fig 1. A 65-year-old-man presented with aphasia and right hemiplegia with a NIHSS score of 22 despite IV tPA. The diagnostic angiogram shows a severe left cervical ICA stenosis (A) and a distal ICA occlusion involving both the left M1 and A1 segments (T-lesion) (B). Carotid stent placement with a 5 x 20-mm Precise stent was performed emergently. The angiographic result after the carotid stent placement is shown in C, and the angiograms at the midthrombolysis and the final recanalization phase are shown in D and E, respectively.