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. 2023 Dec 10:15910199231219021.
doi: 10.1177/15910199231219021. Online ahead of print.

Successful mechanical thrombectomy for terminal ICA bullet embolism: A case report

Jared Clouse  1 , Bart Thaci  2 , Austin Sy Clark  3 , Michael Baggett  4 , Osama Raslan  5 , Charles Matouk  6 , Ben Waldau  1 , Branden Cord  1
Affiliations

Successful mechanical thrombectomy for terminal ICA bullet embolism: A case report

Jared Clouse et al. Interv Neuroradiol. .

Abstract

Bullet embolism after high velocity penetrating trauma is a rare event that can have devastating and wide-ranging effects distant from the original site of injury. A 29-year-old presented with multiple gunshot wounds to the chest, back, abdomen, and lower extremities but no penetrating head injury. After proper resuscitation, the patient was noted to have left-sided hemiparesis and computed tomography angiography of the head showed a bullet fragment that had traveled to the right M1 segment of the middle cerebral artery resulting in occlusion of the vessel. Mechanical thrombectomy was performed in an attempt to remove the bullet fragment but this was unsuccessful as the fragment was firmly lodged in the blood vessel. Aspiration of clot distal to the fragment was then performed in hopes of preventing a large volume ischemic event which was angiographically successful resulting in TICI 2c revascularization. This case demonstrates that thrombectomy can be safely and successfully performed distal to a lodged foreign body.

Keywords: Thrombectomy; bullet embolism; bullet fragment.

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Conflict of interest statement

Declaration of conflicting interestsBranden Cord, MD PhD reports consulting fees from Stryker, QApel, Penumbra, and Silk Road. All other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.