Intravenous Thrombolysis and Three Mechanical Thrombectomies in 15 Days in a Patient with Carotid Web: a Case Report

SN Comprehensive Clinical Medicine volume 3, pages710–714(2021)Cite this article

Abstract

We report the case of a woman with acute ischemic stroke due to recurrent occlusion of the left middle cerebral artery, which occurred three times in 15 days. Only after the third event, digital subtraction angiography detected carotid web (CW) in the left internal carotid artery. Management of CW is still debated and varies from medical therapy to endovascular and surgical approaches, in order to avoid recurrences and outcome worsening. Early arterial reocclusion is associated with poor outcome compared with persistent recanalization. According to the current data, repeated endovascular treatment appears to be a viable option for recurrences and should not be withheld. Intravenous thrombolysis, three mechanical thrombectomies, and stent placing were needed to ensure good outcome in our patient.

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Affiliations

  1. International PhD Translational Molecular Medicine and Surgery, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Policlinico “G. Martino” - Via Consolare Valeria, 1, 98124, Messina, Italy

    Fabrizio Giammello

  2. Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Cristina Dell’Aera, Masina Cotroneo, Carmela Casella, Maria Carolina Fazio, Paolino La Spina, Antonio Ciacciarelli, Rosa Musolino & Francesco Grillo

  3. Neuroradiology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy

    Antonio Armando Caragliano & Agostino Tessitore

  4. Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Antonio Toscano

Authors
  1. Fabrizio Giammello
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  2. Cristina Dell’Aera
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  4. Antonio Armando Caragliano
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  5. Carmela Casella
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  6. Maria Carolina Fazio
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  7. Paolino La Spina
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  11. Rosa Musolino
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  12. Francesco Grillo
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Contributions

F.Gi., C.D., and F.Gr. contributed to the study design. F.Gi., A.C., C.D., and M.C. performed data collections. F.Gi., F.Gr., A.A.C., and A.Te. performed imaging analysis. R.F.M., C.C., M.C.F, P.L.S., and A.To. supervised the research. A. To. provided for English language editing. F.Gi. and F. Gri. wrote the article.

Corresponding author

Correspondence to Fabrizio Giammello.

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The paper does not report on primary research. All data analyzed were collected as part of routine diagnosis and treatment.

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Informed consent was obtained from the patient. We thank the patient and her family for their kind cooperation.

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The authors declare that they have no conflict of interest.

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Giammello, F., Dell’Aera, C., Cotroneo, M. et al. Intravenous Thrombolysis and Three Mechanical Thrombectomies in 15 Days in a Patient with Carotid Web: a Case Report. SN Compr. Clin. Med. 3, 710–714 (2021). https://doi.org/10.1007/s42399-021-00793-8

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Keywords

  • Carotid web
  • Early arterial reocclusion
  • Repeated endovascular treatment
  • Carotid stenting
  • Antiplatelet therapy