1.Mechanical Thrombectomy in a 12-Month-Old Infant with Acute Ischemic Stroke Possibly due to Internal Carotid Artery Dissection: A Case Report
Leila Afshar HEZARKHANI ; Saeed ABDOLLAHIFARD ; Mohammad Hossein MIRBOLOUK ; Shohre HOOSHMAND ; Ashkan MOWLA ; Humain BAHARVAHDAT
Neurointervention 2023;18(2):140-144
Stroke in children is a rare but devastating disease. Although endovascular treatment has been reported to be safe and effective in the treatment of stroke with large vessel occlusion in this population, there are still limitations and controversies. In this case report, we describe a 12-month-old girl who was admitted to the hospital with acute onset of left-sided hemiplegia and confusion, which turned out to be due to a large infarct in the right middle cerebral artery territory, possibly caused by dissection of the right cervical internal carotid artery. Aspiration thrombectomy was successfully performed, and the patient was able to walk a few steps and raise her left upper extremity at the 12-month follow-up. The aspiration-only technique in thrombectomy may be safe and technically feasible to treat acute ischemic stroke with large vessel occlusion in children as young as 12 months, although large-volume prospective studies are needed.
2.Unilateral Oculomotor Nerve Palsy as a Rare Manifestation of Isolated Pre-Communicating Segment of Posterior Cerebral Artery Thrombosis
Farid Qoorchi Moheb SERAJ ; Sajjad NAJAFI ; Hashem PAHLAVAN ; Hossein ORGANJI ; Humain BAHARVAHDAT
Neurointervention 2023;18(3):195-199
Ipsilateral mydriasis (IM) is usually not acute. However, the acute occurrence of unilateral dilated pupil may result in acute ischemic stroke. Herein, we present 3 patients with IM, lateral eye deviation, ptosis, and contralateral hemiparesis due to isolated occlusion of the pre-communicating segment of the posterior cerebral artery with preservation of the posterior communicating artery, which was successfully treated by emergent mechanical thrombectomy. In a 3-month follow-up, all patients were independent without any neurological deficits.
3.Treatment of Traumatic Direct Carotid-Cavernous Fistula with a BeGraft-Covered Stent
Farid Qoorchi Moheb SERAJ ; Sajjad NAJAFI ; Amira Al RAAISI ; Mohammad Hossein MIRBOLOUK ; Feizollah EBRAHIMNIA ; Hashem Pahlavan SHAMSI ; Yousef GARIVANI ; Samira ZABIHYAN ; Ashkan MOWLA ; Humain BAHARVAHDAT
Neurointervention 2024;19(2):111-117
The widely accepted option for treating traumatic direct carotid-cavernous fistula (dCCF) has been endovascular treatment using detachable balloons, coils, or embolic agents. Covered stent deployment has been applied by a few operators and has shown promising results. This is a retrospective study on patients with dCCF treated by an endovascular approach using BeGraft, a covered stent. In 4 cases, this device was successfully deployed without any complications. Immediate complete occlusion was achieved in 3 patients (75%) after deployment of the covered stents. One patient required transvenous coiling for occlusion of the remaining endoleak. Follow-up imaging demonstrated 100% fistula occlusion with complete internal carotid artery patency. No early or late complications occurred following treatment. In conclusion, the BeGraft-covered stent could be a promising safe and effective alternative option for the endovascular treatment of dCCF.