Combined use of invatec mo.ma proximal protection device and Solitaire AB retrievable stent for tandem occlusions in a patient with acute ischemic stroke.

Abstract

Recanalization of tandem vascular occlusions in the setting of an acute stroke is problematic. Here we report a successful treatment of an acute ischemic stroke with tandem cervical internal carotid artery and middle cerebral artery occlusions. A 56-year-old woman presented with acute left-sided hemiplegia. Diffusion magnetic resonance imaging showed an acute infarction in the right frontal and parietal lobes. We planned to perform rescue endovascular treatment after fibrinolytic therapy failed. Stent-assisted carotid angioplasty with proximal embolic protection device was followed by stent-based mechanical thrombectomy of the proximal middle cerebral artery occlusion. Her neurological condition improved after the procedure with National Institutes of Health Stroke Scale of 3 points. The combination of proximal embolic protection device and retrievable Solitaire stent could be a feasible and safe treatment strategy in acute ischemic stroke patients with extra- and intracranial tandem occlusions.