{"id":"d90d2add-74db-4271-8314-939f75ea0924","slug":"iatrogenic-dissection-on-atherosclerotic-stenosis-of-the-middle-cerebral-artery-caused-by-stent-retriever-thrombectomy-for-internal-carotid-artery-embolic-occlusion","title":"Iatrogenic dissection on atherosclerotic stenosis of the middle cerebral artery caused by stent retriever thrombectomy for internal carotid artery embolic occlusion","authors":["Masahiro Morishita","Hideki Endo","Tatsuya Ogino","Kentaro Fumoto","Hirohiko Nakamura"],"abstract":"Background: Arterial dissection is a rare complication of mechanical thrombectomy, and the risk factors and clinical course are not well known. We report a case of iatrogenic dissection on atherosclerotic stenosis of the middle cerebral artery (MCA) caused by stent retriever thrombectomy for internal carotid artery (ICA) embolic occlusion. Case Description: A 78-year-old woman underwent mechanical thrombectomy for ICA embolic occlusion. Preprocedural angiography indicated a thrombus from the C1 segment of the left ICA to the proximal M1 segment of the left MCA and slow antegrade contrast opacification of the mid- to distal-M1. A stent retriever was deployed across the stenotic lesion and pulled back to retrieve a thrombus. Although reperfusion was achieved, mid-M1 occlusion occurred the next day. We considered that endothelial damage from the stent retriever caused iatrogenic dissection at existing atherosclerotic stenosis at mid-M1. Conclusion: Stent retriever thrombectomy can worsen atherosclerotic stenosis. Vascular imaging follow-up is important after thrombectomy in patients with intracranial stenotic lesions. Clinicians should be aware that iatrogenic dissections can be more likely in atherosclerotic vessels following stent retriever thrombectomy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/d90d2add-74db-4271-8314-939f75ea0924/featured/hero-1781558899946.png","publishDate":"2025-02-07T00:00:00.000Z","doi":"10.25259/SNI_928_2024","categories":["Inflammation","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/d90d2add-74db-4271-8314-939f75ea0924/pdf"}