Related Experiment Video
Updated: Jun 10, 2026
The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Thrombosuction for procedural acute thrombosis during high-risk carotid angioplasty--a case report
Anil Dhall1, S K Malani, Davinder S Chadha
1Department of Cardiology, Artemis Health Institute, Gurgaon, India.
Insights
Carotid stenting can be risky with blocked arteries. Direct thrombosuction via a guiding sheath successfully restored blood flow in a patient with acute carotid stent thrombosis, avoiding stroke.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Cerebrovascular Disease
Background:
- Carotid endarterectomy poses high perioperative stroke risk when the contralateral artery is occluded.
- Carotid stenting with neuroprotection is a safer alternative for revascularization in such high-risk cases.
Observation:
- A patient with recurrent transient ischemic attacks and severe left internal carotid artery stenosis, alongside occluded cerebral vessels, underwent high-risk carotid angioplasty.
- Follow-up angiography revealed acute thrombotic obstruction of the carotid stent.
Findings:
- Direct thrombosuction using a guiding sheath effectively cleared the obstruction.
- Complete restoration of vascular patency and intracranial blood flow was achieved.
- A 10-day follow-up angiogram confirmed no residual stenosis or thrombus.
Implications:
- Guiding sheath thrombosuction offers a rapid revascularization strategy for acute carotid stent thrombosis.
- This technique may be crucial in managing complex cerebrovascular cases with high stroke risk.
- Successful thrombosuction can prevent perioperative stroke in patients undergoing carotid stenting with contralateral occlusion.
Abstract:
Carotid endarterectomy in the presence of an occluded contralateral artery is associated with a high risk of perioperative stroke. Carotid stenting with neuroprotection devices has emerged as a safe procedure for revascularization in this circumstance. We performed high-risk carotid angioplasty in a patient with a history of recurrent transient ischemic attacks and 90% stenosis of left internal carotid artery with other occluded cerebral vessels. The final follow-up angiogram revealed thrombotic obstruction of the stent without any evidence of vasospasm, stent deformation or dissection. Direct thrombosuction was performed with the guiding sheath. Multiple suction passes yielded complete restoration of vascular patency and intracranial flows. A control angiogram performed 10 days later revealed no residual stenosis or thrombus. Thrombosuction using a guiding sheath leads to rapid revascularization in a patient with acute carotid stent thrombosis.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care