Direct aspiration first pass technique for a middle cerebral artery occlusion with a hidden aneurysm

Interv Neuroradiol. 2015 Dec;21(6):700-2. doi: 10.1177/1591019915609169. Epub 2015 Oct 15.

Abstract

Hidden aneurysms within occluded vessels present a challenge for interventionists because vessel perforation can lead to life-threatening complications. We present a case of middle cerebral artery ischemic stroke, refractory to thrombolysis. A direct aspiration first pass technique (ADAPT) was employed for revascularization. Following thrombectomy, an aneurysm of the occluded vessel was revealed. Despite this, the patient recovered without hemorrhagic complication. ADAPT permits the minimal insertion of endovascular devices and might be a safe procedure when hidden aneurysms are suspected.

Keywords: Direct aspiration first pass technique (ADAPT); aneurysm; thrombectomy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Diagnosis, Differential
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Middle Cerebral Artery
  • Stroke / diagnostic imaging
  • Stroke / surgery*
  • Suction
  • Thrombectomy / methods*
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator