PMC6700859_01
CT angiography of supra-aortic vessels showing the occlusion of the left
internal carotid artery (a, arrow). Carotid angiogram showing the occlusion
at the origin of the left internal carotid artery (b).
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PMC6700859_01_10.1177_2048004019869162-fig1.jpg
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CT angiogram of supra-aortic vessels confirmed the occlusion of the left internal carotid artery (ICA) excluding hemorrhagic cerebral infarction (Figure 1(a)). Coronary angiography confirmed a proximal occlusion of the RCA, whereas carotid angiogram showed the occlusion at the origin of the left ICA (Figure 1(b)).
Carotid angiogram performed through the MOMA proximal protection system,
showing flow restoration after stent implantation in the internal carotid
artery (a). Cerebral angiogram of intracranial vessels, showing clot
embolization in the middle cerebral artery (b). Middle cerebral artery after
revascularization by balloon PTA (c).
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After providing double proximal and distal cerebral protection with both filter-wire and MOMA system, we first performed thrombus aspiration and then proceeded with stent implantation in the ICA (Figure 2 (a)). A cerebral angiogram, performed to check the status of intracranial vessels, highlighted clot embolization in the middle cerebral artery (Figure 2(b)) requiring immediate revascularization with 2.0/15 mm balloon angioplasty (Figure 2(c)).