Transbrachial Basilar Artery Thrombectomy in a Patient with Aortic Dissection

Abstract Arterial recanalization to restore blood flow in a safe, effective and rapid way is the primary goal in treating hyperacute ischaemic stroke, improving functional outcomes. The clinical benefit of endovascular thrombectomy (EVT) in stroke with large vessel occlusion has been demonstrated and the vascular access route most commonly used for these procedures is the transfemoral approach. When this traditional approach can’t be used, alternative routes, such as the transbrachial ou radial access, may be crucial. In this paper we describe the case of a posterior circulation stroke in a patient with a type A aortic dissection and aortic aneurysm, treated successfully with emergent EVT via the transbrachial access. Given the increasing use of mechanical thrombectomy in acute stroke management and the need to start the treatment as soon as possible it is imperative to optimize all access methods and focus on future studies evaluating alternative vascular approaches.

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Bibliographic Details
Main Authors: Proença,F. B., Raposo,F., Madureira,J. B., Campos,C., Teotónio,P., Neto,L.
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Radiologia e Medicina Nuclear 2020
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512020000300025
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Summary:Abstract Arterial recanalization to restore blood flow in a safe, effective and rapid way is the primary goal in treating hyperacute ischaemic stroke, improving functional outcomes. The clinical benefit of endovascular thrombectomy (EVT) in stroke with large vessel occlusion has been demonstrated and the vascular access route most commonly used for these procedures is the transfemoral approach. When this traditional approach can’t be used, alternative routes, such as the transbrachial ou radial access, may be crucial. In this paper we describe the case of a posterior circulation stroke in a patient with a type A aortic dissection and aortic aneurysm, treated successfully with emergent EVT via the transbrachial access. Given the increasing use of mechanical thrombectomy in acute stroke management and the need to start the treatment as soon as possible it is imperative to optimize all access methods and focus on future studies evaluating alternative vascular approaches.