Prognostic Factors for Neurologic Outcome after Endovascular Revascularization of Acute Symptomatic Occlusion of the Internal Carotid Artery
D.C. Suha,
J.K. Kime,
C.G. Choia,
S.J. Kima,
H.W. Pyuna,
C. Ahnf,
D.H. Yanga,
K.S. Limb,
J.-G. Leemc,
K.D. Hahmc,
J.-H. Leea,
S.U. Kwond and
J.S. Kimd
a Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
b Department of Emergency Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
c Department of Anesthesiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
d Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
e Department of Radiology, Seoul Veterans Hospital, Seoul, Korea
f Department of Medicine, University of Texas–Houston Medical School, Houston, Texas
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Fig 1. A 64-year-old man with cardiac arrhythmia presented with dysarthria, facial palsy, and left-sided weakness. The patient had improvement of the NIHSS score from 14 to 2. His mRS was 1 after 1 year.
A, Anteroposterior view of the right common carotid arteriogram shows complete occlusion of the right ICA.
B, The left ICA arteriogram reveals good leptomeningeal collateral circulation through the anterior cerebral artery. Note the filling defects (arrows) in the right M1 because of intracranial emboli.
C, Reopening of the right ICA bulb with stent placement reveals a residual filling defect (arrow) in the right M2 segment.
D, Final angiogram obtained after intra-arterial administration of thrombolytic agents showed no residual emboli in the middle cerebral arterial branches.
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Fig 2. A 60-year-old man presented with left-sided motor weakness. The patient had improvement of NIHSS score from 9 to 7. His mRS was 4 after 1 year.
A, The right ICA arteriogram shows complete occlusion of the right ICA. Good collateral circulation through the ophthalmic artery reveals no intracranial occlusion.
B, The left ICA arteriogram shows filling of the right anterior cerebral artery through the anterior communicating artery.
C, Vertebral angiogram shows a good leptomeningeal collateral circulation.
D, Microcatheter introduction reveals an occluded end of ICA below the level of the ophthalmic artery. The ICA occlusion could not be revascularized. There was a trigeminal artery variation.
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