The Teaching Point

Innominate artery occlusive stenosis with acute carotid-T thromboembolic occlusion requires early catheter based angiographic evaluation for endovascular intervention. Revascularization using aspiration and mechanical thrombectomy at the carotid terminus simultaneously preceded by innominate artery angioplasty is effective in establishing a favorable clinical outcome.






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From the manuscript

Chronic innominate artery occlusion with hyperacute intracranial thromboembolism: Revascularization with simultaneous local thromboaspiration and mechanical thrombectomy

Free full text article: Chronic innominate artery occlusion with hyperacute intracranial thromboembolism: Revascularization with simultaneous local thromboaspiration and mechanical thrombectomy

Abstract
Chronic innominate artery occlusion with acute right internal carotid terminus thromboembolism and successful revascularization using simultaneous local thromboaspiration and mechanical thrombectomy has not been previously described. A 51-year-old male presented with transient left hemiparesis. A CT angiogram of the head and neck demonstrated chronic occlusion of the right innominate artery with no intracranial thromboembolism. More profound symptoms recurred twelve hours after admission. A diagnostic catheter-based angiogram confirmed occlusion of the innominate artery and identified hyper-acute right carotid terminus thromboembolism. Angioplasty of the innominate artery was followed by simultaneous mechanical and aspiration thrombectomy of the right internal carotid artery terminus. Combination local thromboaspiration and mechanical thrombectomy was shown in this case to be effective in achieving a favorable clinical outcome.






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1. Carotid-T thromboembolism

2. Innominate artery occlusion

3. Middle cerebral artery thromboembolism

4. Thromboaspiration

5. Mechanical thrombectomy


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