Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli

Interv Neuroradiol. 2018 Dec;24(6):674-677. doi: 10.1177/1591019918784259. Epub 2018 Jul 3.

Abstract

Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.

Keywords: Calcified emboli; computed tomography; mechanical thrombectomy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Calcinosis / complications*
  • Calcinosis / diagnostic imaging
  • Cerebral Angiography
  • Cerebral Revascularization / methods*
  • Female
  • Humans
  • Intracranial Embolism / complications*
  • Intracranial Embolism / diagnostic imaging
  • Middle Cerebral Artery / diagnostic imaging
  • Neurosurgical Procedures / instrumentation*
  • Neurosurgical Procedures / methods*
  • Stroke / diagnostic imaging
  • Stroke / etiology*
  • Stroke / surgery*
  • Surgical Instruments
  • Thrombectomy / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome