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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
08:22

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Published on: July 21, 2013

Arterial reocclusion and persistent distal occlusion after thrombus aspiration

Limin Zhao1, Marta Rubiera, Mark R Harrigan

  • 1Comprehensive Stroke Center University of Alabama Hospital, Birmingham, AL 35249, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|June 25, 2010
PubMed
Abstract

Insights

Early reocclusion after clot removal can happen. Glycoprotein IIb/IIIa antagonists may help recanalize persistent distal occlusions not treatable by mechanical methods.

Area of Science:

  • Neuroendovascular therapy
  • Cerebrovascular diseases
  • Interventional neurology

Background:

  • Early reocclusion of intracranial arteries is a significant cause of poor clinical outcomes.
  • Endovascular clot aspiration is a primary treatment for acute ischemic stroke.
  • Monitoring for reocclusion is crucial after mechanical thrombectomy.

Observation:

  • A case of a 73-year-old male with right middle cerebral artery (MCA) occlusion is presented.
  • Reocclusion was detected 30 minutes post-thrombus aspiration using transcranial Doppler (TCD).
  • Persistent M2 MCA occlusion required additional treatment beyond mechanical removal.

Findings:

  • Intravenous abciximab administration under continuous TCD monitoring led to recanalization (TIBI grade 4).
  • The patient showed significant clinical improvement (NIHSS 3) with no hemorrhagic complications.
  • Glycoprotein IIb/IIIa antagonist therapy facilitated recanalization of distal occlusions.

Implications:

  • Continuous TCD monitoring aids in early detection of reocclusion.
  • Glycoprotein IIb/IIIa antagonists are effective for treating reocclusions not amenable to mechanical thrombectomy.
  • This approach may improve outcomes in patients experiencing early reocclusion after endovascular stroke treatment.

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