Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion

Mechanical thrombectomy of tandem occlusion involving the internal carotid artery (ICA) is effective but complex. We discuss ICA rupture during thrombectomy of a tandem ICA occlusion. After crossing the ICA origin, manual angiography in the closed segment between proximal severe stenosis and distal...

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Main Authors: Ariharan K., Sharath Kumar G.G, Somasree Manna
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd.
Series:Journal of Clinical Interventional Radiology ISVIR
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1805006
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author Ariharan K.
Sharath Kumar G.G
Somasree Manna
author_facet Ariharan K.
Sharath Kumar G.G
Somasree Manna
author_sort Ariharan K.
collection DOAJ
description Mechanical thrombectomy of tandem occlusion involving the internal carotid artery (ICA) is effective but complex. We discuss ICA rupture during thrombectomy of a tandem ICA occlusion. After crossing the ICA origin, manual angiography in the closed segment between proximal severe stenosis and distal thrombus leads to ICA rupture. The combination of high pressure created in a closed segment and weak structural points can lead to the rupture. The rupture can happen at the intradural segment of the ICA or an aneurysm. This complication may be avoided by an antegrade approach to tandem occlusions, low-flow microcatheter injections, and common carotid artery injections.
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record_format Article
series Journal of Clinical Interventional Radiology ISVIR
spelling doaj-art-e2481f9ab12040bd843ab4bb4bf13a732025-08-20T02:04:21ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Clinical Interventional Radiology ISVIR2456-486910.1055/s-0045-1805006Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem OcclusionAriharan K.0https://orcid.org/0000-0002-7961-2282Sharath Kumar G.G1https://orcid.org/0000-0002-9501-8988Somasree Manna2https://orcid.org/0000-0003-3650-4756Department of Neuroimaging and Interventional Radiology, First Neuro Hospital, Mangalore, Karnataka, IndiaDepartment of Neuroimaging and Interventional Radiology, Apollo Hospital, Bangalore, Karnataka, IndiaDepartment of Radiodiagnosis, Banaras Hindu University, Varanasi, Uttar Pradesh, IndiaMechanical thrombectomy of tandem occlusion involving the internal carotid artery (ICA) is effective but complex. We discuss ICA rupture during thrombectomy of a tandem ICA occlusion. After crossing the ICA origin, manual angiography in the closed segment between proximal severe stenosis and distal thrombus leads to ICA rupture. The combination of high pressure created in a closed segment and weak structural points can lead to the rupture. The rupture can happen at the intradural segment of the ICA or an aneurysm. This complication may be avoided by an antegrade approach to tandem occlusions, low-flow microcatheter injections, and common carotid artery injections.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1805006ICA rupturetandem occlusionmechanical thrombectomy
spellingShingle Ariharan K.
Sharath Kumar G.G
Somasree Manna
Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
Journal of Clinical Interventional Radiology ISVIR
ICA rupture
tandem occlusion
mechanical thrombectomy
title Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
title_full Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
title_fullStr Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
title_full_unstemmed Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
title_short Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion
title_sort internal carotid artery rupture during mechanical thrombectomy of tandem occlusion
topic ICA rupture
tandem occlusion
mechanical thrombectomy
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1805006
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