A Case of Acute Ischemic Stroke Treated with Endovascular Treatment for Tandem Occlusion of the Common Carotid Artery and Internal Carotid Artery Terminal Portion Related to Takayasu Arteritis

Kentaro Tatsuno; Toshihiro Ueda; Noriko Usuki; Haruki Otsubo; Takashi Araga; Tomohide Yoshie; Satoshi Takaishi; Yasuyuki Yoshida; Hajime Ono

doi:10.5797/jnet.cr.2020-0074

CASE REPORTS

A Case of Acute Ischemic Stroke Treated with Endovascular Treatment for Tandem Occlusion of the Common Carotid Artery and Internal Carotid Artery Terminal Portion Related to Takayasu Arteritis

Kentaro Tatsuno, Toshihiro Ueda, Noriko Usuki, Haruki Otsubo, Takashi Araga, Tomohide Yoshie, Satoshi Takaishi, Yasuyuki Yoshida, Hajime Ono

Author information

Kentaro Tatsuno
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Toshihiro Ueda
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Noriko Usuki
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Haruki Otsubo
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Takashi Araga
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Tomohide Yoshie
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Satoshi Takaishi
Department of Neurology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Yasuyuki Yoshida
Department of Neurosurgery, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan
Hajime Ono
Department of Neurosurgery, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Kanagawa, Japan

Keywords: acute-phase revascularization, mechanical thrombectomy, Takayasu arteritis, aortitis syndrome, occlusion of the common carotid artery

JOURNAL OPEN ACCESS

2021 Volume 15 Issue 6 Pages 387-395

DOI https://doi.org/10.5797/jnet.cr.2020-0074

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Abstract

Objective: This report presents a case of mechanical thrombectomy for left internal carotid artery (ICA) terminal portion occlusion performed by left common carotid artery recanalization during hospitalization after diagnosing bilateral common carotid artery occlusion due to Takayasu arteritis.

Case Presentation: A 25-year-old woman with fever and cervix pain a few months ago visited our department after repeated transient aphasic attacks. Magnetic resonance imaging (MRI) demonstrated diffuse infarction in the left middle cerebral artery (MCA) area, and she was diagnosed with Takayasu arteritis due to bilateral common carotid artery occlusion and left subclavian artery stenosis. On the 20th day of hospitalization, the terminal portion of the left ICA was occluded and thrombectomy was performed after balloon dilation of the left common carotid artery. Lastly, left common carotid artery stenting was performed. Aphasia and sensory disturbance remained, but she was transferred to a rehabilitation hospital with a modified Rankin Scale (mRS) of 2 on the 65th day of hospitalization. Antithrombotic and immunosuppressive therapy were performed, and restenosis did not develop.

Conclusion: Angioplasty and stenting of common carotid artery occlusion can be effective treatments in thrombectomy for intracranial occlusion due to Takayasu disease.

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