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Case Reports
. 2008 Nov;29(10):1956-8.
doi: 10.3174/ajnr.A1221. Epub 2008 Sep 3.

Navigability trumps all: stenting of acute middle cerebral artery occlusions with a new self-expandable stent

P T L Chiam  1 , R M Samuelson, J Mocco, R A Hanel, A H Siddiqui, L N Hopkins, E I Levy
Affiliations
Case Reports

Navigability trumps all: stenting of acute middle cerebral artery occlusions with a new self-expandable stent

P T L Chiam et al. AJNR Am J Neuroradiol. 2008 Nov.

Abstract

Acute stroke intervention is rapidly evolving. New technologies are improving device deliverability and rates of recanalization. We describe 2 cases of acute middle cerebral artery occlusions wherein Wingspan stents could not be delivered to the occlusive site because of excessive vascular tortuosity. Merci thrombectomy was also unsuccessful. Revascularization was only achieved with deployment of the highly navigable Enterprise stent, resulting in thrombolysis in myocardial infarction 2/3 flow. Thus, all devices should be considered in the armamentarium of stroke therapy.

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Figures

Fig 1.
Fig 1.
A, Angiogram showing severe tortuosity of the left ICA. B, Neuron guide catheter (arrow) positioned deep in the ICA. C, Intracranial angiogram showing distal M1 occlusion. D, Recanalization of the M1 immediately after stent placement.
Fig 2.
Fig 2.
A, Angiogram showing tortuosity of the cavernous ICA and occlusion of the proximal M1. B, Recanalization of the M1 immediately after stent placement.
See this image and copyright information in PMC

References

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