Mechanical thrombectomy in a patient with acute ischemic stroke caused by bilateral carotid artery occlusion: A case report
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Abstract
Acute bilateral carotid artery occlusion is an extremely rare cause of stroke and is associated with a very poor prognosis if not treated promptly. Early bilateral recanalization is the only effective option to preserve neurological function. We report the case of a 44-year-old woman with a history of heart failure and atrial fibrillation. Six hours after permanent pacemaker implantation, she suddenly became comatose with a Glasgow Coma Scale (GCS) score of 6. Computed tomography angiography revealed complete occlusion of the right common carotid artery and complete occlusion of the left internal carotid artery at its origin. The patient underwent mechanical thrombectomy using a direct aspiration-first approach performed sequentially on each side. Successful bilateral carotid artery recanalization was achieved 46 minutes after femoral artery puncture, with a final TICI score 3 on both sides. At 24 hours after reperfusion, the patient showed marked neurological improvement, returned to full consciousness (GCS 15), with a NIHSS score of 4. This case highlights a rare but severe clinical presentation requiring immediate endovascular intervention to achieve rapid recanalization and optimize neurological outcomes.
Article Details
Keywords
Ischemic stroke, carotid artery occlusion, aspiration thrombectomy
References
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