Direct Carotid Puncture for Endovascular Thrombectomy in a 96-Year-Old Patient with Acute Cerebral Infarction:A Case Report Kengo NISHIMURA 1 , Shogo KAKU 1,2 , Toru SANO 2 , Masahide WATANABE 2 , Tetsuaki IWAMOTO 2 , Yuichi MURAYAMA 1 1Department of Neurosurgery, Jikei University School of Medicine 2Noshinkeigeka Higashiyokohama Hospital Keyword: direct carotid puncture , thrombectomy pp.797-802
Published Date 2018/9/10
DOI https://doi.org/10.11477/mf.1436203816
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 We report a case of direct carotid puncture for endovascular thrombectomy in a 96-year-old patient with acute cerebral infarction. Anatomical difficulties of carotid artery access, including an unfavorable aortic arch type and the tortuosity of carotids, could have resulted in a recanalization delay or failure in patients with acute ischemic stroke.

 A 96-year-old woman developed sudden right hemiparesis. By initiating thrombectomy, we could not access the common carotid artery;therefore, we performed a direct carotid puncture on the neck and achieved successful recanalization with improvement of hemiparesis. We discuss the limitations and technical aspects of this technique.

 We conclude that in case of stroke, a direct carotid artery puncture is a feasible alternative to an anatomically difficult transfemoral access.

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