Mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report

Abstract

BACKGROUND

Mechanical thrombectomy (MT) has been demonstrated to be useful for the treatment of ischemic stroke in patients with large vessel occlusions. However, recanalization by MT is not recommended for distal vessels such as second-order branches of the middle cerebral artery and posterior inferior cerebellar artery (PICA). Because of the small size and tortuosity of these arteries, the risks of using the available endovascular devices outweigh the benefits of treatment. However, MT appears to be effective in patients with primary distal vessel occlusion in eloquent areas, those with a high National Institutes of Health Stroke Scale score, and those ineligible for recombinant tissue plasminogen activator therapy. Here, we report the use of MT for treating acute occlusion of the PICA using a direct-aspiration first-pass technique (ADAPT).

CASE SUMMARY

In this case, the patient received acute occlusion of the PICA with ADAPT when right internal carotid artery stenting was performed.

CONCLUSION

With the introduction of advanced endovascular devices, MT may now be a feasible treatment for acute occlusion of the PICA.

Keywords: Posterior inferior cerebellar artery; Mechanical thrombectomy; Ischemic stroke; Carotid artery stent; Neurovascular interventions; Case report

Core Tip: Mechanical thrombectomy, such as a direct-aspiration first-pass technique, can be performed in a cautiously selective manner in patients with occlusion of a posterior circulation branch with a smaller size and tortuosity, such as the posterior inferior cerebellar artery, and obtain a good clinical outcome.