Emergency microsurgical embolectomy after failure of endovascular recanalization for embolic occlusion of the anterior intracranial artery [Anterior intrakranyal arterin embolik oklüzyonunu için endovasküler rekanalizasyonun başarısızlığı sonrasında acil mikrocerrahi]

Objectives: although the first-line treatment option for ischemic stroke due to intracranial artery occlusion is endovascular recanalization,this type of endovascular treatment can be associated with failure of recanalization of the occluded artery. in case of failure of this approach,surgical embolectomy might be a final effective therapeutic option,if case selection is adequate. here,we present the surgical results of microsurgical embolectomy of an intracranial artery occlusion after failure of endovascular recanalization.methods: seven patients with acute occlusion of the distal internal cerebral artery (ica) and the middle cerebral artery (mca) were treated with microsurgical embolectomy. occlusion occurred in the distal ica in 3 patients and in the mca in 4 patients. we investigated patients' clinical characteristics,admission time,occlusion time,and collateral flow.results: two patients were men and 5 patients were women; their mean age was 68.4 years. the mean admission time was 112.9 min. although recanalization was achieved intraoperatively in all patients,1 elder patient died on the first postoperative day. the mean occlusion time was 6.8 h. the mca conduction time was grade 1 in 1 patient,grade 2 in 1 patient,grade 3 in 1 patient,and grade 5 in 1 patient. at 6 months after the operation,1 patient had grade 3 on the modified rankin scale and 5 patients had grade 2.conclusions: microsurgical embolectomy may be an ultimate effective therapeutic option for recanalization in selected patients,especially in cases of failure of endovascular recanalization. © 2014,ege university press. all rights reserved.