case_images: PMC11758864_01
case_images: Digital subtraction angiography (DSA) of anterior circulation in posterior-anterior projection. (A) DSA in the posterior-anterior projection showed that the right internal carotid artery (ICA) did not send out the anterior cerebral artery (ACA). (B) DSA in the posterior-anterior projection showed bilateral ACAs originating from the left ICA, and both ACAs were occluded in their A2 segment (red arrow).
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case_images: PMC11758864_01_IMCRJ-18-125-g0001.jpg
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case_images: Digital subtraction angiography (DSA) in the posterior-anterior projection showed the bilateral A2 segments ACAs originating from the left A1 segment, and both bilateral A2 segments ACAs were occluded (Figure 1).
case_images: Mechanical thrombectomy of bilateral anterior cerebral arteries (ACAs) and left middle cerebral artery (MCA) and diffusion weighted imaging (DWI) images after thrombectomy. (A) A stent retriever (RECO RVV-I-4-20) was employed in the right ACA and good recanalization was achieved in the first pass. (B) Some clots were found in the stent retriever after the first thrombectomy trial with the stent retriever. (C) Bilateral ACAs were completely reperfused with modified thrombolysis in cerebral ischemia (mTICI) 3 after the respective first thrombectomy trial with the stent retriever, but secondary thrombi were found in the MCA bifurcation (green arrow). (D) Most thrombi were removed from the left MCA using a direct aspiration technique. (E) Bilateral ACAs and left MCA were completely reperfused with mTICI 3 after the first thrombectomy trial. (F) Postprocedural magnetic resonance angiography brain DWI showed a recent infarction in the bilateral ACA and part of the left MCA territory (white arrow).
case_images: IMCRJ-18-125-g0002.jpg
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case_images: ACAs (Figure 2). After the respective first thrombectomy trial with the stent retriever, the bilateral ACAs were completely reperfused with modified thrombolysis in cerebral ischemia 3, but secondary thrombi were found in the