Simultaneous Bilateral Carotid Thrombectomies: A Technical Note

Thomas Larrew; Zachary Hubbard; Eyad Almallouhi; Chirantan Banerjee; Mark Moss; Alejandro M Spiotta

doi:10.1093/ons/opz230

Simultaneous Bilateral Carotid Thrombectomies: A Technical Note

Oper Neurosurg (Hagerstown). 2020 May 1;18(5):E143-E148. doi: 10.1093/ons/opz230.

Authors

Thomas Larrew¹, Zachary Hubbard¹, Eyad Almallouhi², Chirantan Banerjee², Mark Moss³, Alejandro M Spiotta¹

Affiliations

¹ Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina.
² Department of Neurology, Medical University of South Carolina, Charleston, South Carolina.
³ Department of Neurosurgery, Washington Regional Medical Center, Fayetteville, Arkansas.

PMID: 31504828
DOI: 10.1093/ons/opz230

Abstract

Background: Although extremely rare, acute bilateral large vessel occlusion (LVO) is a morbid condition that requires prompt intervention.

Objective: To report the technique used to achieve recanalization of bilateral internal carotid artery (ICA) terminus occlusions.

Methods: This is a case of bilateral ICA terminus occlusions managed with simultaneous bilateral thrombectomies with poor collateral circulation.

Results: Recanalization of bilateral ICA with thrombolysis in cerebral infarction (TICI) grade 0 to left TICI 2b flow with distal left A1 occlusion and right TICI 3 flow was achieved in 32 min with the use of simultaneous catheterization and aspiration thrombectomies.

Conclusion: The described technique offers an efficient and feasible means to reduce time to recanalization and radiation in cases of bilateral LVO.

Keywords: Aspiration; Bilateral carotid occlusion; Stroke; Thrombectomy.

Publication types

Case Reports

MeSH terms

Carotid Artery Diseases* / diagnostic imaging
Carotid Artery Diseases* / surgery
Carotid Artery, Internal / diagnostic imaging
Carotid Artery, Internal / surgery
Humans
Stents*
Thrombectomy
Treatment Outcome