Empty microcatheter technique for the deployment of a self-expanding stent to treat refractory middle cerebral artery occlusion in the setting of severe proximal tortuosity

Abstract

We report a case of an acute middle cerebral artery (M2 segment) occlusion that was refractory to intravenous tissue plasminogen activator (IV t-PA), thrombectomy with the Merci® device, intra-arterial infusion of urokinase and eptifibatide, and balloon angioplasty. The artery was so tortuous that over-the-wire stent placement failed and a salvage technique was required to place the self-expanding stent. © 2008 by the American Society of Neuroimaging.