[A male patient with acute, reversible blindness]

Intra-arterial thrombectomy (IAT) in occlusions of the posterior cerebral artery (PCA) is uncommon and not a proven therapeutic solution, but can be performed in individual cases.

An 80 year old man visited the emergency room after experiencing acute blindness. This was caused by a new hemianopia for the left visual field due to an occlusion of the right PCA, on top of a pre-existing hemianopia for the right visual field. Auxiliary testing showed an old ischemic stroke of the right occipital lobe, and a new occlusion of the right PCA. After deliberation with the patient, it was decided to perform IAT, because of the debilitating effect of the current neurological disabilities. IAT was succesfull and the patient completely recovered to the pre-existing level of functioning.

Although there is no indisputable evidence to suggest that IAT in occlusions of the PCA is safe and effective, this case illustrates that IAT can be considered on an individual basis. Based on individual patient characteristics and shared decision making, IAT can be performed after carefull consideration of the risks and benefits.