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Distal occlusion thrombectomy with Solitaire™ X 3mm

Author: Fandiño Eduardo

Find out how Dr. Eduardo Fandiño treated a 93-year-old female patient with an episode of acute dysarthria, right oculocephalic deviation, and left hemiparesis.

Thursday 26 January 2023
  • Case presentation
    • 93-year-old female patient
    • Inpatient due to TIAs of 1-5 minutes without acute signs of ischemic brain in NECT
    • 3 days later, at 07:20 AM, episode of acute dysarthria, right oculocephalic deviation, and left hemiparesis
    • NIHSS 9

     

    ASPECTS 10

    ASPECTS 10
    There was a chronic lesion lateral to the right ventricular atrium not counted in ASPECTS

     

    CBF & Tmax

    The purple area was the chronic lesion not counted in ASPECTS

     

    Right M1 occlusion in the CT-Angio

    Right M1 occlusion in the CT-Angio

     

    M2 occlusion of the inferior division of the MCA

     

    • IV rTPA 0.9ml/kg administration and activation of thrombectomy protocol
    • Conscious sedation in the angio suite
    • M2 occlusion of the inferior division of the MCA

     

    TICI 2B after aspiration once with REDTM 62

  • Conclusion

     

    • Post-endovascular treatment TICI 3
    • After a second pass of direct aspiration with REDTM 62 in combination with SOLITAIRE TM X 3mm

     

    Non-contrast CT after 24 hours of thrombectomy

     

    • Non-contrast CT after 24 hours of thrombectomy revealed no hemorrhage or any other complication
    • The patient was discharged with NIHSS 0 and mRS 1 after 3 days from the thrombectomy (total of 6 days in hospital)

     

  • This case is sponsored by Medtronic.

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