Mechanical thrombectomy for occlusion of the fenestrated middle cerebral artery M1 segment: A case report and review of the literature

• DOI: 10.1016/j.radcr.2024.01.071
• Publication Date: 2024-02-13T23:38:36Z
• Authors: Kiyonori Kuwahara; Ichiro Nakahara; Shoji Matsumoto; Yoshio Suyama; Jun Morioka; Akiko Hasebe; Jun Tanabe; Sadayoshi Watanabe; Kenichiro Suyama; Yuichi Hirose
• Keywords: Fenestration; Digital subtraction angiography; Stroke; Penumbra

It is impossible to predict underlying anomalies in acute large vessel occlusion and it could be a problem when performing mechanical thrombectomy (MT). We report case of MT for the fenestrated middle cerebral artery (MCA) M1 segment. A 49-year-old woman presented our hospital with dysarthria left hemiparesis. Acute ischemic stroke due right occluded MCA was diagnosed. During emergent MT, part segment revealed slit-shaped by digital subtraction angiography, suggesting MCA. The aspiration catheter not advanced through narrow limb fenestration, distal thrombus retrieved using stent retriever, additionally. Postoperatively, patient's symptoms improved without complications. When suspected, necessary consider converting strategy from an alone combined use retriever.