Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2021; 9(10): 2268-2273
Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2268
Mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report
Hong-Bo Zhang, Pian Wang, Yan Wang, Jiang-Hong Wang, Zheng Li, Rong Li
Hong-Bo Zhang, Pian Wang, Yan Wang, Jiang-Hong Wang, Zheng Li, Rong Li, Department of Neurology, Chengdu Fifth People's Hospital, Chengdu 611130, Sichuan Province, China
Author contributions: Zhang HB and Wang P contributed equally to this work; Zhang HB and Wang P executed the procedure and wrote the manuscript; Wang JH, Li R, and Li Z contributed the figure descriptions; Wang Y contributed the review and figure descriptions; all authors issued final approval for the version to be submitted.
Supported by Youth Innovation Project of Medical Research in Sichuan Province, No. Q18012.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Wang, MD, Chief Physician, Department of Neurology, Chengdu Fifth People's Hospital, No. 33 Mashi Road, Wenjiang District, Chengdu 611130, Sichuan Province, China. 17340085006@163.com
Received: August 23, 2020
Peer-review started: August 23, 2020
First decision: December 21, 2020
Revised: January 1, 2021
Accepted: February 1, 2021
Article in press: February 1, 2021
Published online: April 6, 2021
Processing time: 218 Days and 17.9 Hours
Abstract
BACKGROUND

Mechanical thrombectomy (MT) has been demonstrated to be useful for the treatment of ischemic stroke in patients with large vessel occlusions. However, recanalization by MT is not recommended for distal vessels such as second-order branches of the middle cerebral artery and posterior inferior cerebellar artery (PICA). Because of the small size and tortuosity of these arteries, the risks of using the available endovascular devices outweigh the benefits of treatment. However, MT appears to be effective in patients with primary distal vessel occlusion in eloquent areas, those with a high National Institutes of Health Stroke Scale score, and those ineligible for recombinant tissue plasminogen activator therapy. Here, we report the use of MT for treating acute occlusion of the PICA using a direct-aspiration first-pass technique (ADAPT).

CASE SUMMARY

In this case, the patient received acute occlusion of the PICA with ADAPT when right internal carotid artery stenting was performed.

CONCLUSION

With the introduction of advanced endovascular devices, MT may now be a feasible treatment for acute occlusion of the PICA.

Keywords: Posterior inferior cerebellar artery; Mechanical thrombectomy; Ischemic stroke; Carotid artery stent; Neurovascular interventions; Case report

Core Tip: Mechanical thrombectomy, such as a direct-aspiration first-pass technique, can be performed in a cautiously selective manner in patients with occlusion of a posterior circulation branch with a smaller size and tortuosity, such as the posterior inferior cerebellar artery, and obtain a good clinical outcome.