title: Direct aspiration first pass technique for a middle cerebral artery occlusion with a hidden aneurysm.
abstract: Hidden aneurysms within occluded vessels present a challenge for interventionists because vessel perforation can lead to life-threatening complications. We present a case of middle cerebral artery ischemic stroke, refractory to thrombolysis. A direct aspiration first pass technique (ADAPT) was employed for revascularization. Following thrombectomy, an aneurysm of the occluded vessel was revealed. Despite this, the patient recovered without hemorrhagic complication. ADAPT permits the minimal insertion of endovascular devices and might be a safe procedure when hidden aneurysms are suspected.
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan asai-osk@umin.ac.jp.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Asai
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Stroke Division, Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakaguchi
authors.affiliation: Stroke Division, Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawano
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ozaki
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ima
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kidani
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kadono
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D003937:Diagnosis, Differential; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D020768:Middle Cerebral Artery; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D013396:Suction; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Direct aspiration first pass technique (ADAPT); aneurysm; thrombectomy