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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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A technique for prevention of posterior stroke during urgent revascularization of an acutely ischemic left upper

Lauren M Heyda1, Kai Hata2, Erin Koelling2

  • 1Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD.

Journal of Vascular Surgery Cases and Innovative Techniques
|August 19, 2024
PubMed

Upper extremity acute limb ischemia (ALI) owing to obstruction proximal to the vertebral artery poses the risk of posterior stroke during intervention. We describe a case of upper extremity ALI secondary to thrombosis of the proximal left subclavian artery with thromboembolic occlusion at the brachial bifurcation. The patient underwent a hybrid procedure of open thromboembolectomy with endovascular vertebral artery embolic protection. The patient's distal pulses and upper extremity function returned to baseline, without evidence of posterior stroke. A literature review revealed limited reports of the use of cerebral embolic protection in the setting of emergent thromboembolectomy for upper extremity ALI.

Keywords:
Cerebral embolic protectionIschemic strokeLarge vessel occlusionThromboembolectomyUpper extremity arterial occlusionUpper limb ischemia

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