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Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):305-8.

Endovascular mechanical thrombectomy of an occluded superior division branch of the left MCA for acute cardioembolic stroke.

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The Neurological Institute, Doris & Stanley Tananbaum Stroke Center, New York Presbyterian Hospital, College of Physicians & Surgeons of Columbia University, Box 131, 710 West 168th Street, New York, NY 10032, USA.


Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhage as time passes from stroke onset. We report successful mechanical thrombectomy from a distal branch of the middle cerebral artery (MCA) using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due to a recent myocardial infarction. Intraarterial administration of 4 mg rt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours, symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents.

[Indexed for MEDLINE]

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