Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery
Introduction: Fetal posterior cerebral artery (FPCA) occlusion is a rare but potentially disabling cause of stroke. While endovascular treatment is established for acute large vessel occlusion (LVO) stroke, FPCA occlusions were excluded from acute ischemic stroke trials. We aim to report the feasibi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000207 |
| _version_ | 1797948383076286464 |
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| author | Mohamad Abdalkader Mohamad Abdalkader Anurag Sahoo Adam A Dmytriw Waleed Brinjikji Guilherme Dabus Eytan Raz Leonardo Renieri Antonio Laiso Alberto Maud Mario Martinez‐Galdamez Jorge Galvan‐Fernandez Miguel Schuller Arteaga Fawaz Al‐Mufti Krishna Amuluru Johanna T Fifi Shahram Majidi Priyank Khandelwal Justin Moore Nicole Kiley Santiago Ortega‐Gutierrez Ameer E Hassan James E Siegler Simon Nagel Osama O Zaidat Thanh N Nguyen |
| author_facet | Mohamad Abdalkader Mohamad Abdalkader Anurag Sahoo Adam A Dmytriw Waleed Brinjikji Guilherme Dabus Eytan Raz Leonardo Renieri Antonio Laiso Alberto Maud Mario Martinez‐Galdamez Jorge Galvan‐Fernandez Miguel Schuller Arteaga Fawaz Al‐Mufti Krishna Amuluru Johanna T Fifi Shahram Majidi Priyank Khandelwal Justin Moore Nicole Kiley Santiago Ortega‐Gutierrez Ameer E Hassan James E Siegler Simon Nagel Osama O Zaidat Thanh N Nguyen |
| author_sort | Mohamad Abdalkader |
| collection | DOAJ |
| description | Introduction: Fetal posterior cerebral artery (FPCA) occlusion is a rare but potentially disabling cause of stroke. While endovascular treatment is established for acute large vessel occlusion (LVO) stroke, FPCA occlusions were excluded from acute ischemic stroke trials. We aim to report the feasibility, safety and outcome of mechanical thrombectomy (MT) in acute FPCA occlusions. Methods: We performed a multi‐center retrospective review of consecutive patients who underwent MT of acute FPCA occlusion. Primary FPCA occlusion was defined as an occlusion that was identified on the pre‐procedure CT angiogram or baseline angiogram whereas a secondary FPCA occlusion was defined as an occlusion that occurred secondary to embolization to a new territory after recanalization of a different LVO. Demographics, clinical presentation, imaging findings, endovascular treatment and outcome were reviewed. Results: There were twenty‐five patients with acute FPCA occlusion who underwent MT, distributed across 14 centers. Median NIHSS on presentation was 16. There were 76% (19/25) of patients who presented with primary FPCA occlusion and 24% (6/25) of patients who had a secondary FPCA occlusion. The configuration of the FPCA was full in 64% patients and partial or “fetal‐type” in 36% of patients. FPCA occlusion was missed on initial CTA in 21% of patients with primary FPCA occlusion (4/19). The site of occlusion was posterior communicating artery in 52%, P2 segment in 40% and P3 in 8% of patients. TICI 2b/3 reperfusion was achieved in 96% of FPCA patients. There were no intra‐procedural complications. At 90 days, 48% (12/25) were functionally independent as defined by mRS≤2. Conclusions: Endovascular treatment of acute FPCA occlusion is safe and technically feasible. A high index of suspicion is important to detect occlusion of the fetal posterior cerebral artery in patients presenting with anterior circulation stroke syndrome and patent anterior circulation. |
| first_indexed | 2024-04-10T21:42:26Z |
| format | Article |
| id | doaj.art-583aeabeb0fe43bd942d897aab1a8e43 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-04-10T21:42:26Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-583aeabeb0fe43bd942d897aab1a8e432023-01-18T21:39:24ZengWileyStroke: Vascular and Interventional Neurology2694-57462021-11-011S110.1161/SVIN.01.suppl_1.000207Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral ArteryMohamad Abdalkader0Mohamad Abdalkader1Anurag Sahoo2Adam A Dmytriw3Waleed Brinjikji4Guilherme Dabus5Eytan Raz6Leonardo Renieri7Antonio Laiso8Alberto Maud9Mario Martinez‐Galdamez10Jorge Galvan‐Fernandez11Miguel Schuller Arteaga12Fawaz Al‐Mufti13Krishna Amuluru14Johanna T Fifi15Shahram Majidi16Priyank Khandelwal17Justin Moore18Nicole Kiley19Santiago Ortega‐Gutierrez20Ameer E Hassan21James E Siegler22Simon Nagel23Osama O Zaidat24Thanh N Nguyen25Boston Medical Center Boston United States of AmericaBoston Medical Center Boston United States of AmericaBoston Medical Center Boston United States of AmericaMassachusetts General Hospital, Boston Massachusetts United States of AmericaMayo Clinic, Rochester Minnesota United States of AmericaMiami Cardiac and Vascular Institute & Baptist Neuroscience Center Miami United States of AmericaNYU Langone, New York City New York United States of AmericaUniversity Hospital Careggi Firenze ItalyUniversity Hospital Careggi Firenze ItalyTexas Tech University Health Sciences Center, El Paso Texas United States of AmericaHospital Clinico Universitario de Valladolid Valladolid SpainHospital Clinico Universitario de Valladolid Valladolid SpainHospital Clinico Universitario de Valladolid Valladolid SpainWestchester Medical Center at New York Medical College, Valhalla New York United States of AmericaGoodman Campbell Brain and Spine, Ascension St. Vincent Medical Center, Indianopolis Indiana United States of AmericaMount Sinai, New York City New York United States of AmericaMount Sinai, New York City New York United States of AmericaRutgers University, Newark New Jersey United States of AmericaBeth Israel Deaconness Medical Center, Boston Massachusetts United States of AmericaBoston Medical Center Boston United States of AmericaUniversity of Iowa Hospitals and Clinics, Iowa City Iowa United States of AmericaUniversity of Texas Rio Grande Valley, Valley Baptist Medical Center, Harlingen Texas United States of AmericaCooper Neurological Institute, Cooper University Hospital, Camden New Jersey United States of AmericaHeidelberg University Hospital Heidelberg GermanySt. Vincent Mercy Hospital, Toledo Ohio United States of AmericaBoston Medical Center Boston United States of AmericaIntroduction: Fetal posterior cerebral artery (FPCA) occlusion is a rare but potentially disabling cause of stroke. While endovascular treatment is established for acute large vessel occlusion (LVO) stroke, FPCA occlusions were excluded from acute ischemic stroke trials. We aim to report the feasibility, safety and outcome of mechanical thrombectomy (MT) in acute FPCA occlusions. Methods: We performed a multi‐center retrospective review of consecutive patients who underwent MT of acute FPCA occlusion. Primary FPCA occlusion was defined as an occlusion that was identified on the pre‐procedure CT angiogram or baseline angiogram whereas a secondary FPCA occlusion was defined as an occlusion that occurred secondary to embolization to a new territory after recanalization of a different LVO. Demographics, clinical presentation, imaging findings, endovascular treatment and outcome were reviewed. Results: There were twenty‐five patients with acute FPCA occlusion who underwent MT, distributed across 14 centers. Median NIHSS on presentation was 16. There were 76% (19/25) of patients who presented with primary FPCA occlusion and 24% (6/25) of patients who had a secondary FPCA occlusion. The configuration of the FPCA was full in 64% patients and partial or “fetal‐type” in 36% of patients. FPCA occlusion was missed on initial CTA in 21% of patients with primary FPCA occlusion (4/19). The site of occlusion was posterior communicating artery in 52%, P2 segment in 40% and P3 in 8% of patients. TICI 2b/3 reperfusion was achieved in 96% of FPCA patients. There were no intra‐procedural complications. At 90 days, 48% (12/25) were functionally independent as defined by mRS≤2. Conclusions: Endovascular treatment of acute FPCA occlusion is safe and technically feasible. A high index of suspicion is important to detect occlusion of the fetal posterior cerebral artery in patients presenting with anterior circulation stroke syndrome and patent anterior circulation.https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000207Acute StrokeAcute Ischemic Stroke InterventionMechanical ThrombectomyEndovascular Therapy |
| spellingShingle | Mohamad Abdalkader Mohamad Abdalkader Anurag Sahoo Adam A Dmytriw Waleed Brinjikji Guilherme Dabus Eytan Raz Leonardo Renieri Antonio Laiso Alberto Maud Mario Martinez‐Galdamez Jorge Galvan‐Fernandez Miguel Schuller Arteaga Fawaz Al‐Mufti Krishna Amuluru Johanna T Fifi Shahram Majidi Priyank Khandelwal Justin Moore Nicole Kiley Santiago Ortega‐Gutierrez Ameer E Hassan James E Siegler Simon Nagel Osama O Zaidat Thanh N Nguyen Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery Stroke: Vascular and Interventional Neurology Acute Stroke Acute Ischemic Stroke Intervention Mechanical Thrombectomy Endovascular Therapy |
| title | Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery |
| title_full | Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery |
| title_fullStr | Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery |
| title_full_unstemmed | Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery |
| title_short | Abstract 1122‐000207: Mechanical Thrombectomy of the Fetal Posterior Cerebral Artery |
| title_sort | abstract 1122 000207 mechanical thrombectomy of the fetal posterior cerebral artery |
| topic | Acute Stroke Acute Ischemic Stroke Intervention Mechanical Thrombectomy Endovascular Therapy |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.01.suppl_1.000207 |
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