Korean Journal of Stroke 2011 ; 13 (3) : p.147~151
Successful Endovascular Mechanical Thrombolysis in a Patient with Hyperacute Tandem Occlusions of Middle Cerebral Artery and Extracranial Internal Carotid Artery
(중간대뇌동맥과 두개외 속목동맥의 급성 일렬폐색에 의한 초급성 뇌경색 환자에서 성공적인 혈관내 물리적 혈전제거치료 성공 증례)
저자 유동우1,이시백1·한시령1·김범수2·박형은1·배대웅1·구자성1
논문 종류 Case Reports 전문 보기 10 KJS11-30(147-151).pdf
Previous studies have shown that patients with tandem occlusions involving extracranial internal carotid artery (ICA) and middle
cerebral artery (MCA) have lower likelihood of recanalization by standard intravenous thrombolytic therapy. A 70-years-old man with a history of hypertension was admitted because of left hemiplegia and drowsiness which developed 47 minutes ago.
On neurologic examination, he was drowsy and showed neglect syndrome as well as left hemiplegia. Brain CT angiography showed tandem occlusions at right extracranial ICA and proximal MCA. The administration of intravenous (IV) tissue plasminogen activator (tPA) did not improve his symptoms. We performed angioplasty and stenting for proximal ICA occlusion followed by mechanical thrombolysis for MCA occlusion. After the endovascular treatment, the MCA was recanalized and the patient recovered to show only mild left side weakness. This case shows successful treatment of hyperacute ischemic infarction from tendem occlusion of right MCA and proximal ICA with endovascular treatment following IV tPA thrombolysis. (Korean J Stroke 2011;13:147-151)

KEY WORDS: Tandem occlusion, Mechanical thrombolysis, Cerebral infarction