PMC9610213_01
Case 1: Initial magnetic resonance imaging, diffusion-weighted image (a and b), and magnetic resonance arteriography (c) results at stroke onset. Acute lesions are visualized in the left corona radiata and temporal lobe. Magnetic resonance arteriography shows a left internal carotid artery occlusion. MCA: Middle cerebral artery.
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F1
On presentation, cranial magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) showed ICA occlusion and acute and subacute infarctions in the left ICA territory on the MRI diffusion-weighted image sequences [Figure 1].
Case 1: Angiography reveals left internal carotid artery occlusion (a) and the development of pial anastomoses from the anterior communicating artery and left posterior cerebral artery to left anterior cerebral artery and middle cerebral artery (b and c).
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F2
Aichi, Japan) was delivered to the left ICA. Angiography revealed a tapered occlusion of the left ICA and moderate pial anastomosis in the left middle cerebral artery (MCA) territory from the left anterior and posterior cerebral arteries [Figure 2].
Case 1: Angiography of the left ICA. The stent retriever fails to open completely at the occluded point (a). After prolonged deployment with stent retriever for 30 min, the left ICA is occluded (b). Following the removal of the stent retriever and microcatheter, the left ICA recanalizes with stenosis (c). ICA: Internal carotid artery.
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F3
This event similarly indicated atherothrombotic disease as the underlying pathology [Figure 3a]. After occlusion for a 2nd time, the Solitaire was partially resheathed into the microcatheter to reduce the radial force and minimize vessel injury during the pull [Figure 3b]. After the removal of the microcatheter, the ICA recanalized with stenosis over 30 min [Figure 3c], and the right hemiparesis remarkably improved.
PMC9610213_02
Case 2: Initial magnetic resonance imaging, diffusion-weighted image (a), and magnetic resonance arteriography (b) images at stroke onset. Acute lesions are visualized in the left watershed territories between anterior cerebral artery, middle cerebral artery, and posterior cerebral artery. Magnetic resonance arteriography shows a proximal left internal carotid artery occlusion.
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F4
On presentation, cranial MRI/MRA showed ICA occlusion and acute and subacute infarctions in the left watershed territories between the anterior cerebral artery, MCA, and posterior cerebral arteries on the MRI diffusion-weighted image sequences [Figure 4].
Case 2: Angiography of the left ICA. The stent retriever fails to open completely at the occluded point (a). After prolonged deployment with stent retriever for 10 min, the left ICA is occluded (b). Following the removal of the stent retriever and microcatheter, the left ICA recanalizes with stenosis (c). ICA: Internal carotid artery.
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F5
After occlusion for a 3rd time, the Solitaire was partially resheathed into the microcatheter to reduce the radial force and minimize vessel injury during the pull [Figures 5a and b]. After the removal of the microcatheter, the ICA recanalized with mild stenosis over 30 min [Figure 5c].