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Fig 2. A 69-year-old woman with an NIHSS score of 17 who was noted to have a right hemiplegia and aphasia was given an IV bolus dose of tPA because she presented less than 3 hours from symptom onset. She was transferred on an emergency basis to our institution and referred for IA therapy.
A, Angiography (anteroposterior view) reveals a left M1 MCA occlusion (black arrow) with a large anterior temporal branch.
B, A 3.5- x 20-mm Neuroform 3 stent was deployed across the focal area of occlusion after administering an IV bolus dose of eptifibatide (180 µg/kg). Recanalization (TIMI/TICI 3 flow) was re-established in the posterior division of the MCA (dotted black arrow).
C, An unsubtracted image reveals the proximal and distal edges of the stent (black arrowheads).
D, A follow-up run reveals that the anterior division of the MCA is now also patent, but there are filling defects within the stent (arrow demonstrates filling of branch vessels with a filling defect in one of the branches). The patient improved on the day after the procedure to an NIHSS score of 10.
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