Patient situation
72-year-old female with global aphasia, right hemisyndrome, and gaze deviation to the left (NIHSS 20) 1.5 hours after a motor vehicle accident
Left carotid-T occlusion
Suspected left choroid plexus papilloma as an incidental finding
Rapid AI perfusion analysis
Treatment
| Treatment chosen
|
- EVT with direct aspiration using a large-bore aspiration catheter
|
| Devices used
|
- SOFIA Flow 88 Aspiration Catheter, WEDGE XL Delivery catheter
|
| Description of the treatment
|
- GA
- Right femoral puncture, insertion of a 5F short sheath
- After diagnostic angiography, insertion of an 8F Arrow sheath (80 cm) via exchange maneuver (Supracor exchange wire) into the left cervical ICA
- Advancement of a SOFIA Flow 88 Aspiration Catheter over an Asahi Chikai black-14 microwire and a WEDGE XL Delivery Catheter in front of the clot
- Aspiration thrombectomy using 2x 60 mL interlocked syringes for aspiration
- First-pass complete reperfusion (mTICI 3)
|
Diagnostic angiogram in AP and lateral projections depicting a left carotid-T occlusion
Delivery of a SOFIA Flow 88 large-bore aspiration catheter (arrow) over an Asahi Chikai black-14 microwire and a WEDGE XL Delivery Catheter (arrowhead)
First-pass complete reperfusion success (mTICI 3) after one aspiration thrombectomy attempt
Results
- First-pass complete reperfusion after one aspiration thrombectomy attempt (mTICI 3)
- After EVT, moderate residual aphasia and apraxia of the right upper extremity (NIHSS 7), with further improvement to NIHSS 3 at discharge
Supported by Terumo Neuro
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