Case of “Slow” Stroke from Carotid Artery Occlusion Treated by Delayed but Cautious Endovascular Intervention英文文献资料.docVIP

SAGE-HindawiAccesstoResearch StrokeResearchandTreatment Volume2011,ArticleID974357,5pages doi:10.4061/2011/974357 CaseReport Caseof“Slow”StrokefromCarotidArteryOcclusionTreatedby DelayedbutCautiousEndovascularIntervention KachiIlloh, EmilioSupsupin, HashemM.Shaltoni, andEdwinD.Cacayorin 1 2 3 2 1 2 3 DivisionofNeurologyProducts,CenterforDrugEvaluationandResearch,U.S.FoodandDrugAdministration,Building22, Room5402,10903NewHampshireAvenue,SilverSpring,MD20993,USA Department of Diagnostic andInterventional Imaging, The Universityof TexasMedicalSchool at Houston, 6431 Fannin Street, MSB2.130B,Houston,TX77030,USA DepartmentofRadiology,BaylorCollegeofMedicine,OneBaylorPlaza,MailStopBCM360,Houston,TX77030,USA CorrespondenceshouldbeaddressedtoKachiIlloh,kachikwu.illoh@ Received30November2010;Accepted22February2011 AcademicEditor:OsamaO.Zaidat Copyright?2011KachiIllohetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. In a challenging case of carotid occlusion with slowly evolving stroke, we used brain imaging to facilitate endovascular revascularizationresultinginthereliefofthepatient’ssymptoms.Patientswithcarotidocclusionandcontinuedneurological worsening or ?uctuations present enormous treatment challenges. These patients may present “slow” strokes with subacute infarctsthatpresentsigni?cantchallengesandrisksduringattemptsatrevascularizationoftheoccludedartery.Wepresentsucha caseinwhichweusedmultimodalimagingtechniques,includingMR-perfusion,tofacilitateendovascularrevascularization.Our approachofdelayedbutcautiousintra-arterialthrombolytictherapy,guidedbybrainimaging,andfollowedbystentplacement acrosstheresidualstenosis,enabledrevascularizationoftheoccludedarterywithoutovertin-hospitalcomplications. 1.Introduction this case is to raise awareness of management challenges