A Case of Acute Embolic Occlusion of the Common Carotid Artery in Which a Giant Thrombus Was Retrieved Using the Parallel Stent Retriever Technique

Tenyu Hino; Masayuki Sato; Mikito Hayakawa; Aiki Marushima; Yoshiro Ito; Taisuke Akimoto; Sho Okune; Takato Hiramine; Ryosuke Shintoku; Eiichi Ishikawa; Yuji Matsumaru

doi:10.5797/jnet.cr.2020-0164

A Case of Acute Embolic Occlusion of the Common Carotid Artery in Which a Giant Thrombus Was Retrieved Using the Parallel Stent Retriever Technique

J Neuroendovasc Ther. 2022;16(2):87-92. doi: 10.5797/jnet.cr.2020-0164. Epub 2021 May 11.

Authors

Tenyu Hino¹, Masayuki Sato^{1

2}, Mikito Hayakawa^{1

3}, Aiki Marushima^{1

2}, Yoshiro Ito^{1

2}, Taisuke Akimoto^{1

2}, Sho Okune^{1

2}, Takato Hiramine¹, Ryosuke Shintoku^{1

2}, Eiichi Ishikawa², Yuji Matsumaru^{1

2

3}

Affiliations

¹ Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
² Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
³ Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Abstract

Objective: We report a case of embolic occlusion of the common carotid artery (CCA) in which a giant thrombus was retrieved using the parallel stent retriever technique.

Case presentation: An 84-year-old woman without anticoagulant therapy despite a history of cardioembolic stroke presented to our hospital because of left hemiparesis after developing sudden vision loss in her right eye. Emergency angiography revealed a giant thrombus in the right CCA. After arresting flow in the CCA using a balloon-guided catheter (BGC), we deployed two stent retrievers in parallel from the internal carotid artery to the CCA, and slowly retrieved them simultaneously under manual aspiration through the BGC. As a result, complete recanalization was achieved.

Conclusion: Thrombi causing acute embolic occlusion of the CCA are often too large to be completely retrieved using conventional thrombectomy techniques. The parallel stent retriever technique may be effective in such cases.

Keywords: cardiogenic embolism; embolic occlusion of the common carotid artery; endovascular thrombectomy; giant thrombus.

Publication types

Case Reports