Empty microcatheter technique for the deployment of a self-expanding stent to treat refractory middle cerebral artery occlusion in the setting of severe proximal tortuosity

J Neuroimaging. 2009 Apr;19(2):164-8. doi: 10.1111/j.1552-6569.2008.00252.x. Epub 2008 Apr 3.

Abstract

We report a case of an acute middle cerebral artery (M2 segment) occlusion that was refractory to intravenous tissue plasminogen activator (IV t-PA), thrombectomy with the Merci device, intra-arterial infusion of urokinase and eptifibatide, and balloon angioplasty. The artery was so tortuous that over-the-wire stent placement failed and a salvage technique was required to place the self-expanding stent.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon
  • Brain / blood supply
  • Brain / pathology
  • Brain / surgery
  • Catheterization / methods*
  • Eptifibatide
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Infarction, Middle Cerebral Artery / etiology
  • Infarction, Middle Cerebral Artery / pathology
  • Infarction, Middle Cerebral Artery / surgery*
  • Infusions, Intra-Arterial
  • Injections, Intravenous
  • Miniaturization
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Peptides / therapeutic use
  • Platelet Aggregation Inhibitors / administration & dosage
  • Stents*
  • Thrombectomy
  • Tissue Plasminogen Activator / therapeutic use
  • Urokinase-Type Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • Peptides
  • Platelet Aggregation Inhibitors
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
  • Eptifibatide