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CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR
DOI: 10.1055/s-0045-1805006
Case Report

Internal Carotid Artery Rupture during Mechanical Thrombectomy of Tandem Occlusion

Ariharan K. 
1   Department of Neuroimaging and Interventional Radiology, First Neuro Hospital, Mangalore, Karnataka, India
,
Sharath Kumar G.G 
2   Department of Neuroimaging and Interventional Radiology, Apollo Hospital, Bangalore, Karnataka, India
,
Somasree Manna 
3   Department of Radiodiagnosis, Banaras Hindu University, Varanasi, Uttar Pradesh, India
› Author Affiliations Funding None.
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Abstract

Mechanical thrombectomy of tandem occlusion involving the internal carotid artery (ICA) is effective but complex. We discuss ICA rupture during thrombectomy of a tandem ICA occlusion. After crossing the ICA origin, manual angiography in the closed segment between proximal severe stenosis and distal thrombus leads to ICA rupture. The combination of high pressure created in a closed segment and weak structural points can lead to the rupture. The rupture can happen at the intradural segment of the ICA or an aneurysm. This complication may be avoided by an antegrade approach to tandem occlusions, low-flow microcatheter injections, and common carotid artery injections.

Keywords

ICA rupture - tandem occlusion - mechanical thrombectomy

Declaration

All authors contributed to this case report.




Publication History

Article published online:
24 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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