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Case Reports
. 2024 Oct 16;47(1):800.
doi: 10.1007/s10143-024-03031-6.

Correspondence: Microsurgical thrombectomy: Where the ancient art meets the new era

Dylan Penders  1 , Maarten Vanloon  2 , Barbara Verbraeken  3   4 , Süleyman Sener  5 , Ingrid Baar  3   6   7 , Caroline Loos  3   8   7 , Maurits Voormolen  3   9   7 , Tomas Menovsky  3   10   7
Affiliations
Case Reports

Correspondence: Microsurgical thrombectomy: Where the ancient art meets the new era

Dylan Penders et al. Neurosurg Rev. .

Abstract

Surgical thrombectomy remains a feasible technique in an accurately selected patient population with large vessel occlusion, even though endovascular mechanical thrombectomy is the gold standard. It especially warrants consideration in cases where the endovascular approach is unfeasible or fails. The current extension in the therapeutic window of time in mechanical thrombectomy also provides opportunities to open thrombectomy. To support our view, we present a case of a patient who suffered an ischemic stroke. Intravenous thrombolysis proved ineffective and mechanical thrombectomy was impossible due to extreme tortuosity of the internal carotid artery. Therefore, surgical thrombectomy was performed. The patient underwent successful recovery and states a great satisfaction. To improve efficiency and outcomes, a properly organised and trained surgical team with plentiful neurovascular experience is necessary. Finally, open thrombectomy is the most effective approach to completely restore luminal patency compared to the endovascular approaches yet risks due to the operation should be taken into account.

Keywords: Arteriotomy; Large vessel occlusion; Stroke; Surgical thrombectomy.

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References

    1. Ota N, Benet A, Kusdiansah M, Miyoshi N, Haraguchi K, Noda K et al (2024) Microsurgical thrombectomy: where the ancient art meets the new era. Neurosurg Rev 47(1):49. https://doi.org/10.1007/s10143-024-02281-8 - DOI - PubMed
    1. Hino A, Oka H, Hashimoto Y, Echigo T, Koseki H, Fujii A et al (2016) Direct Microsurgical Embolectomy for Acute occlusion of the Internal Carotid Artery and Middle cerebral artery. World Neurosurg 88:243–251. https://doi.org/10.1016/j.wneu.2015.12.069 - DOI - PubMed
    1. Welch K (1956) Excision of occlusive lesions of the middle cerebral artery. J Neurosurg 13(1):73–80. https://doi.org/10.3171/jns.1956.13.1.0073 - DOI - PubMed
    1. Thongphetsavong Gautam A, Seh H, Jain A, Mechri I, van Jan P, Dammers R et al (2021) Open Microvascular Thrombectomy for Acute Intracranial large vessel occlusion: Microsurgery in the endovascular thrombectomy era. World Neurosurg 145:e278–e90. https://doi.org/10.1016/j.wneu.2020.10.040 - DOI - PubMed
    1. Meyer FB, Piepgras DG, Sundt TM Jr., Yanagihara T (1985) Emergency embolectomy for acute occlusion of the middle cerebral artery. J Neurosurg 62(5):639–647. https://doi.org/10.3171/jns.1985.62.5.0639 - DOI - PubMed

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