Addressing P1 Occlusion: A Successful Distal Thrombectomy

Author: ROUCHAUD Aymeric

• Case presentation
  • Male
  • 86-year-old
  • Atrial fibrillation
  • Previous intracranial haematoma
  • 10:00 am: right deficit+ aphasia
  • NIHSS 14
  • MRI at 1:20 pm

  
• Intervention

  DWI - 1:20 pm

  

  T2* - 1:20 pm 

  

  FLAIR - 1:20 pm

  

   

  TOF MRA - P1 occlusion - 1:20 pm

  

   

  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

  

   

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

  
• Results

  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.