Zenith devices used in this case:

Patient Information

• Female, 73 years old
• A patient presented with speech impairment, right-sided limb weakness, and altered consciousness for approximately 3 hours.
• Clinical diagnosis: Left middle cerebral artery occlusion
• Surgical plan: Stent retriever thrombectomy + balloon angioplasty + stent implantation

Preoperative Angiography

Devices

• Zenith Distal Access Catheter
• Zenith Stent Retriever
• Long Sheath
• Ballon-mounted stent

Procedure

Under guidance of a multipurpose catheter, a 6F long sheath was advanced to the C1 segment of the left internal carotid artery. Zenith Distal Access Catheter was positioned at the C6 segment. A microcatheter was navigated through the occlusion over a microwire. After withdrawal of the microwire, contrast injection confirmed that the microcatheter was within the true lumen and identified the occlusion segment.

Zenith Stent Retriever was deployed at the occlusion site, revealing M1 segment stenosis of the middle cerebral artery, confirming this as an ICASO event. After 5 minutes of integration, the stent was retrieved, yielding a small amount of thrombus.

Follow-up angiography showed persistent severe stenosis at the M1 segment. Balloon angioplasty was performed, followed by tirofiban administration for antiplatelet therapy, but the blood flow remained unstable. A 2.5×18 mm balloon-mounted stent was then implanted, resulting in significant improvement in vessel patency.

Postoperative Angiography

Surgeon Information

Wenxin Lei and Biao Ma, The First People's Hospital of Jinzhong