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FIG 3. Case 18. Mechanical disruption with a J-shaped microguidewire during thrombolytic therapy (A–C) and local angiograms from a microcatheter (D–F).
A and B, J-shaped tip (arrows) is moved from a position proximal to the embolus (A) to a distal position (B).
C, J-shaped tip (arrow) is rotated in the embolus.
D, AP view shows that the MCA M1 segment is occluded (arrow) just distal to the orifice of the anterior cerebral artery (arrowheads). Dislodgment of the embolus from the distal ICA to the mid-M1 segment is indicated.
E, AP view shows dislodgment of the embolus to the MCA M2 segment (arrow). The exact location of the embolus is difficult to identify on this view.
F, Lateral view shows fragmented emboli in the M2 segments of the parietal (arrow) and angular (arrowhead) arteries.
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