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Mechanical Thrombectomy of an Embolic Middle Cerebral Artery/M1 Occlusion: First-Pass Effect in Acute Large Vessel Occlusion

The Ischemic Stroke Casebook

  • 34 Accesses

Abstract

Complete or near-complete reperfusion of large vessel occlusion (LVO) is the goal of thrombectomy. Reperfusion of LVO in only one pass (first-pass reperfusion, FPR) is associated with a better clinical outcome, called first-pass effect (FPE), and it can be considered the goal of the endovascular treatment of LVO, when achievable.

We describe a representative case of FPE in a 77-year-old female patient with a cardioembolic acute occlusion of right MCA/M1, with atrial fibrillation that suspended anticoagulation before a scheduled surgery. After one-pass thrombectomy with a stent retriever and distal aspiration, reperfusion was achieved. First-pass reperfusion, with complete regression of neurological deficit and a good clinical outcome (FPE), is the topic of this chapter.

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Abbreviations

ACA:

Anterior cerebral artery

ASPECTS:

Alberta Stroke Program Early CT Score

BGC:

Balloon guide catheter

CT:

Computed tomography

FPE:

First-pass effect

FPR:

First-pass reperfusion

ICA:

Internal carotid artery

IV:

Intravenous

LVO:

Large vessel occlusion

MCA:

Middle cerebral artery

mRS:

Modified Rankin Scale

NIHSS:

National Institute of Health Stroke Scale

p.m.:

Post meridiem

PA:

Posterior-anterior

PCA:

Posterior cerebral artery

PO:

Per os

TICI:

Thrombolysis in Cerebral Infarction

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Authors and Affiliations

  1. Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany

    Carmen Serna-Candel, Alexandru Cimpoca & Hans Henkes

  2. Neurologische Klinik, Klinikum Stuttgart, Stuttgart, Germany

    Marc E. Wolf & Hansjörg Bäzner

Authors
  1. Carmen Serna-Candel
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  2. Alexandru Cimpoca
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  3. Marc E. Wolf
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  4. Hansjörg Bäzner
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  5. Hans Henkes
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Corresponding author

Correspondence to Carmen Serna-Candel .

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Editors and Affiliations

  1. Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Baden-Württemberg, Germany

    Hans Henkes

  2. Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel

    José E. Cohen

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Serna-Candel, C., Cimpoca, A., Wolf, M.E., Bäzner, H., Henkes, H. (2022). Mechanical Thrombectomy of an Embolic Middle Cerebral Artery/M1 Occlusion: First-Pass Effect in Acute Large Vessel Occlusion. In: Henkes, H., Cohen, J.E. (eds) The Ischemic Stroke Casebook. Springer, Cham. https://doi.org/10.1007/978-3-030-85411-9_14-2

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  • DOI: https://doi.org/10.1007/978-3-030-85411-9_14-2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-85411-9

  • Online ISBN: 978-3-030-85411-9

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  1. Latest

    Mechanical Thrombectomy of an Embolic Middle Cerebral Artery/M1 Occlusion: First-Pass Effect in Acute Large Vessel Occlusion
    Published:
    01 May 2022

    DOI: https://doi.org/10.1007/978-3-030-85411-9_14-2

  2. Original

    Mechanical Thrombectomy of an Embolic Middle Cerebral Artery/M1 Occlusion: First-Pass Effect in Acute Large Vessel Occlusion
    Published:
    08 March 2022

    DOI: https://doi.org/10.1007/978-3-030-85411-9_14-1

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