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Addressing P1 Occlusion: A Successful Distal Thrombectomy

Last update on September 5, 2023
Case presentation
  • Male
  • 86-year-old
  • Atrial fibrillation
  • Previous intracranial haematoma
  • 10:00 am: right deficit+ aphasia
  • NIHSS 14
  • MRI at 1:20 pm
Previous intracranial haematoma
Intervention

DWI - 1:20 pm

1:20 PM - DWI

T2* - 1:20 pm 

1:20 PM - T2*

FLAIR - 1:20 pm

1:20 PM - FLAIR

 

TOF MRA - P1 occlusion - 1:20 pm

TOF MRA - P1 occlusion

 

Drip and ship procedure

No IV tPA (previous intracerebral haematoma) ➔ Transfert to Limoges University Hospital for MT ➔ Arrival at 3:50 pm

Before - 4:15 pm - NeuronMAX™ / Phenom™21 / Solitaire™ 3x20

Before 4:15pm - Neuron MAX / Phenom 21 / Solitaire 3x20

 

After - 4:32 pm - NeuronMAX™ / Phenom™ 21 / Solitaire™ 3x20

After 4:32pm - Neuron MAX / Phenom 21 / Solitaire 3x20
Results

24 hours CT - NIHSS 1 at day 4

24 hours CT - NIHSS 1 at day 4

  

Distal thrombectomy with Solitaire™ 3 mm

  • Excellent navigability and visibility of the device
  • Navigation through a 0.17 or 0.21 micro
  • 0.17 in case of inital MeVO
  • 0.21 if persistent distal clot after initial LVO

 

This case is sponsored by Medtronic.

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