<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0017_s_006_w2aab3b7c62b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Acute bilateral internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusion is extremely rare and associated with poor clinical outcomes. There are only a few reports in the literature about mechanical thrombectomy being performed for acute bilateral occlusions. The treatment strategies and prognoses (clinical outcomes) are therefore unclear.</p></sec><sec id="j_raon-2020-0017_s_007_w2aab3b7c62b1b6b1aab1c16b2Aa"><h3>Methods</h3><p>A systematic review of the literature was performed through several electronic databases with the following search terms: acute bilateral stroke, mechanical recanalization and thrombectomy.</p></sec><sec id="j_raon-2020-0017_s_008_w2aab3b7c62b1b6b1aab1c16b3Aa"><h3>Results</h3><p>In the literature, we identified five reports of six patients with bilateral ICA and/or MCA occlusion treated with mechanical recanalization. Additionally, we report our experience with a subsequent contralateral large brain artery occlusion during intravenous thrombolytic therapy, where the outcome after mechanical thrombectomy was not dependent on the time from stroke onset but rather on the capacity of collateral circulation exclusively.</p></sec><sec id="j_raon-2020-0017_s_009_w2aab3b7c62b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Acute bilateral cerebral (ICA and/or MCA) occlusion leads to sudden severe neurological deficits (comas) with unpredicted prognoses, even when mechanical recanalization is available. As the collateral capacity seems to be more important than the absolute time to flow restoration in determining the outcomes, simultaneous thrombectomy by itself probably does not lead to improved functional outcomes.</p></sec></abstract>

BackgroundAcute bilateral internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusion is extremely rare and associated with poor clinical outcomes. There are only a few reports in the literature about mechanical thrombectomy being performed for acute bilateral occlusions. The treatment strategies and prognoses (clinical outcomes) are therefore unclear.MethodsA systematic review of the literature was performed through several electronic databases with the following search terms: acute bilateral stroke, mechanical recanalization and thrombectomy.ResultsIn the literature, we identified five reports of six patients with bilateral ICA and/or MCA occlusion treated with mechanical recanalization. Additionally, we report our experience with a subsequent contralateral large brain artery occlusion during intravenous thrombolytic therapy, where the outcome after mechanical thrombectomy was not dependent on the time from stroke onset but rather on the capacity of collateral circulation exclusively.ConclusionsAcute bilateral cerebral (ICA and/or MCA) occlusion leads to sudden severe neurological deficits (comas) with unpredicted prognoses, even when mechanical recanalization is available. As the collateral capacity seems to be more important than the absolute time to flow restoration in determining the outcomes, simultaneous thrombectomy by itself probably does not lead to improved functional outcomes.

Mechanical recanalization for acute bilateral cerebral artery occlusion – literature overview with a case

Radiology and Oncology

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BackgroundAcute bilateral internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusion is extremely rare and associated with poor clinical...

Mechanical recanalization for acute bilateral cerebral artery occlusion – literature overview with a case

Article Category: Review

Online veröffentlicht: 26. März 2020

Seitenbereich: 144 - 148

Eingereicht: 19. Jan. 2020

Akzeptiert: 05. März 2020

DOI: https://doi.org/10.2478/raon-2020-0017

© 2020 Miran Jeromel, Zoran V Milosevic, Janja Pretnar Oblak, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.