Case report: Navigating the challenges: successful mechanical thrombectomy in a case of persistent primitive hypoglossal artery

Kamran Ahmed Khan; Irfan Amjad Lutfi; Jehangir Ali Shah; Salman Farooq; Shahnoor Ahmed; Bashir Ahmed Solangi; Ayan Ahmed Khan; Fazal Zaidi; Ali Ammar; Nadeem Qamar

doi:10.3389/fneur.2023.1248506

Case report: Navigating the challenges: successful mechanical thrombectomy in a case of persistent primitive hypoglossal artery

Front Neurol. 2023 Nov 24:14:1248506. doi: 10.3389/fneur.2023.1248506. eCollection 2023.

Affiliations

¹ Department of Adult Cardiology & Neurology, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
² Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
³ Student of Foundation Public School, Karachi, Pakistan.
⁴ Department of Neurology, University of Toledo, Toledo, OH, United States.

Abstract

Persistent primitive hypoglossal artery (PPHA) is a highly uncommon abnormal connection between the internal carotid artery (ICA) and vertebral artery (VA), with reported incidences ranging from 0.027 to 0.26%. Attempting endovascular intervention in such cases presents a considerable challenge as it carries a higher risk of embolization and other procedure-related complications that may affect a wide area of the brain. We present a case study involving the utilization of mechanical thrombectomy (MT) to treat an ischemic stroke in the M1 segment of the middle cerebral artery (MCA) despite the presence of PPHA. Performing mechanical thrombectomy in an anomalous vascular connection is feasible; however, it necessitates heightened vigilance, thorough knowledge of the anatomy, and utmost caution.

Keywords: MCA; PPHA; mechanical thrombectomy; persistent primitive hypoglossal artery; stroke.

Publication types

Case Reports