Mechanical thrombectomy for occlusion of the fenestrated middle cerebral artery M1 segment: A case report and review of the literature

Kiyonori Kuwahara, MD, PhD; Ichiro Nakahara, MD, PhD; Shoji Matsumoto, MD, PhD; Yoshio Suyama, MD, PhD; Jun Morioka, MD, PhD; Akiko Hasebe, MD, PhD; Jun Tanabe, MD, PhD; Sadayoshi Watanabe, MD, PhD; Kenichiro Suyama, MD, PhD; Yuichi Hirose, MD, PhD

Radiology Case Reports (May 2024)

Mechanical thrombectomy for occlusion of the fenestrated middle cerebral artery M1 segment: A case report and review of the literature

Kiyonori Kuwahara, MD, PhD,
Ichiro Nakahara, MD, PhD,
Shoji Matsumoto, MD, PhD,
Yoshio Suyama, MD, PhD,
Jun Morioka, MD, PhD,
Akiko Hasebe, MD, PhD,
Jun Tanabe, MD, PhD,
Sadayoshi Watanabe, MD, PhD,
Kenichiro Suyama, MD, PhD,
Yuichi Hirose, MD, PhD

Affiliations

Kiyonori Kuwahara, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan; Corresponding author.
Ichiro Nakahara, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Shoji Matsumoto, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Yoshio Suyama, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Jun Morioka, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Akiko Hasebe, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Jun Tanabe, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Sadayoshi Watanabe, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Kenichiro Suyama, MD, PhD: Department of Comprehensive Strokology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
Yuichi Hirose, MD, PhD: Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan

Journal volume & issue: Vol. 19, no. 5
pp. 1692 – 1696

Abstract

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It is impossible to predict underlying anomalies in acute large vessel occlusion and it could be a problem when performing mechanical thrombectomy (MT). We report a case of MT for occlusion of the fenestrated middle cerebral artery (MCA) M1 segment. A 49-year-old woman presented to our hospital with dysarthria and left hemiparesis. Acute ischemic stroke due to right occluded MCA was diagnosed. During performing emergent MT, a part of the M1 segment was revealed to be slit-shaped by digital subtraction angiography, suggesting a fenestrated MCA. The aspiration catheter could not be advanced through the narrow limb of the fenestration, and the distal thrombus was retrieved using a stent retriever, additionally. Postoperatively, the patient's symptoms improved without complications. When occlusion of the fenestrated MCA is suspected, it is necessary to consider converting the strategy from an aspiration catheter alone to the combined use of a stent retriever.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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Abstract

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