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Updated: Jul 21, 2025

Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Mechanical Thrombectomy for ICA Top Occlusion with Twig-Like MCA: A Case Report
Yu Sakai1, Gakushi Yoshikawa1, Katsuya Sato1
1Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan.
Objective:
We report a case of hemorrhagic complication after mechanical thrombectomy (MT) for internal carotid artery (ICA) occlusion with twig-like middle cerebral artery (MCA).
Case Presentation:
A 75-year-old man was admitted to our hospital with ICA occlusion. Recanalization was achieved by a direct aspiration first pass technique (ADAPT). The peripheral MCA was twig-like, but operators thought that a thrombus remained in the MCA first segment. The procedure was continued and suspended with perforation of the microguidewire.
Conclusion:
When performing MT for large vessel occlusion (LVO) with twig-like MCA, it is difficult to proceed a device to the periphery and there is a risk of hemorrhage.
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