Rescue stenting in Acute Ischemic Stroke

[lmthang]

Patient male, 67 yrs, suddently left hemiplegia 7 hrs ago, admission for stupor and:
- Left hemiplegia.
- Left facial hemiplegia.
- Aphasia
- NIHSS 23 pts.
- mRS 5 pts.
Result MRI 3 Tesla: Right middle cerebral artery (RMCA) occlusion because of thrombose. Acute cerebral ischemia near right lateral ventricle.


Result DSA: RMCA occlusion M1 segment.

Treatment:
- Mechanical thrombectomy 1 time but severe stenosis RMCA M1 segment.

- 1 Clopidogrel 300 mg + 2 Aspirin 81 mg via nasogastric intubation.
- Angioplasty + Intracranial stenting

Result after neurointervention: mTICI III.
Clinical signs:
- Coma because of sedatives; mRS 5 pts.
- CT scan: Intracranial hematoma (-).

- Using dual antiplatelet therapy (Clopidogrel 75 mg + aspirin 81 mg) q.d PO.
- After 5 days: left hemiparesis improvement 4/5; mRS 2 pts.