{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:28:18Z","timestamp":1761823698874},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"unspecified","delay-in-days":3502,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. j. neurol. sci."],"published-print":{"date-parts":[[2005,5]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:sec id=\"S031716710000408X_abs1\"><jats:title>Background and purpose:<\/jats:title><jats:p>Cervical internal carotid artery (ICA) occlusion associated with middle cerebral artery (MCA) embolic occlusion requires prompt revascularization to prevent devastating stroke. With the advent of endovascular techniques for chemical and mechanical thrombolysis, the clinical outcome of patients with major arterial occlusions will improve. Finding the most expedient pathway to the site of end organ occlusion for thrombolysis is important.<\/jats:p><\/jats:sec><jats:sec id=\"S031716710000408X_abs2\"><jats:title>Methods:<\/jats:title><jats:p>We present two cases of acute stroke secondary to thrombotic occlusion of the cervical ICA associated with MCA embolic occlusion treated with intra-arterial thrombolysis via catheter navigation through the posterior communicating artery to the site of MCA arterial occlusion. No attempt was made to transverse the occluded ICA.<\/jats:p><\/jats:sec><jats:sec id=\"S031716710000408X_abs3\"><jats:title>Results:<\/jats:title><jats:p>Near complete restoration of flow was achieved in one patient and minimal vessel reopening was observed in the other patient. Both patients had good outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S031716710000408X_abs4\"><jats:title>Conclusion:<\/jats:title><jats:p>Intraarterial thrombolysis via Circle of Willis collaterals such as the posterior communicating artery for the treatment of acute thrombotic occlusion of the cervical internal carotid artery associated with embolic occlusion of the middle cerebral artery is a therapeutic option. This treatment option avoids the potential complications of navigating through an occluded proximal internal carotid artery and may expedite reopening of the MCA.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s031716710000408x","type":"journal-article","created":{"date-parts":[[2014,12,12]],"date-time":"2014-12-12T15:33:05Z","timestamp":1418398385000},"page":"257-260","source":"Crossref","is-referenced-by-count":8,"title":["Intra-arterial Thrombolysis of Embolic Middle Cerebral Artery Using Collateral Pathways"],"prefix":"10.1017","volume":"32","author":[{"given":"Max K.","family":"Kole","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Pelz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald H.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Jain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. David","family":"Spence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Lownie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,12,2]]},"reference":[{"key":"S031716710000408X_ref014","first-page":"904","article-title":"Combined intravenous and intra-arterial recanalization for acute ischemic stroke: the Interventional Management of Stroke Study","volume":"35","year":"2004"},{"key":"S031716710000408X_ref012","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200211000-00040"},{"key":"S031716710000408X_ref011","first-page":"783","article-title":"Intra-arterial suction thrombectomy in acute stroke","volume":"23","author":"Lutsep","year":"2002","journal-title":"AJNR Am JNeuroradiol"},{"key":"S031716710000408X_ref010","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000064841.47697.22"},{"key":"S031716710000408X_ref009","first-page":"1823","article-title":"Perfusion- anddiffusion-weighted MR imaging-guided therapy of vertebral artery dissection: intra-arterial thrombolysis through an occipital vertebral anastomosis","volume":"24","author":"Restrepo","year":"2003","journal-title":"AJNR Am J Neuroradiol"},{"key":"S031716710000408X_ref006","first-page":"692","volume-title":"Interventional Neuroradiology: Strategies and Practical Techniques","author":"Connors","year":"1999"},{"key":"S031716710000408X_ref005","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.21.2003"},{"key":"S031716710000408X_ref001","first-page":"1791","article-title":"Angioplasty of theoccluded carotid artery","volume":"16","author":"Spearman","year":"1995","journal-title":"AJNR Am J Neuroradiol"},{"key":"S031716710000408X_ref007","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.3.0387"},{"key":"S031716710000408X_ref013","first-page":"279","article-title":"Acute intravenous-intra-arterial revascularization therapy for severe ischemic stroke","volume":"33","author":"Hill","year":"2002"},{"key":"S031716710000408X_ref004","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199402000-00023"},{"key":"S031716710000408X_ref008","first-page":"491","volume-title":"Neuroimaging Clinics of North America","volume":"9","author":"Burnette","year":"1999"},{"key":"S031716710000408X_ref002","first-page":"1169","article-title":"Results of urgentthrombolysis in patients with major stroke and atherothrombotic occlusion of the cervical carotid artery","volume":"19","author":"Endo","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"S031716710000408X_ref003","first-page":"1596","article-title":"Complete recoveryafter early intra-arterial recombinant tissue plasminogen activator thrombolyis of carotid T occlusion","volume":"23","author":"Rabinstein","year":"2002","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S031716710000408X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T20:59:38Z","timestamp":1556917178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S031716710000408X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,5]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2005,5]]}},"alternative-id":["S031716710000408X"],"URL":"https:\/\/doi.org\/10.1017\/s031716710000408x","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,5]]}}}