{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:46:02Z","timestamp":1786124762640,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"suppl_1","license":[{"start":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T00:00:00Z","timestamp":1560470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We present the case of a 62-yr-old female who presented with ground-level fall and new onset of left-sided weakness of 30 min duration. CT angiogram revealed right ICA pseudo-occlusion and thrombus filling the right proximal M1 segment of the right MCA. On detailed neurological exam patient was noted to have NIHSS of 25. Patient was started on IV TPA infusion and was taken to interventional angiography suite after an informed consent was obtained. Diagnostic angiography was performed which demonstrated critical stenosis of the right proximal internal carotid artery. Right carotid artery stenting and balloon angioplasty of the carotid stent with distal embolic protection device was performed. Post carotid stent angiogram once again confirmed proximal right M1 pseudo-occlusion in the right MCA distribution. The clot was removed using a stent retriever, thus achieving complete recanalization (TICI 3) of the right cerebral hemisphere. The patient returned to baseline neurological status and a 1 mo follow-up diagnostic angiogram revealed patent carotid stent. Following the case presentation, we present the nuances of acute ischemic stroke management of large vessel occlusion with an emphasis on technical nuances, recent published guidelines\n                    <jats:sup>1<\/jats:sup>\n                    and the literature.\n                    <jats:sup>2-8<\/jats:sup>\n                  <\/jats:p>","DOI":"10.1093\/neuros\/nyz084","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T08:36:32Z","timestamp":1552379792000},"page":"S74-S75","source":"Crossref","is-referenced-by-count":1,"title":["Thrombectomy for a Patient with Concomitant Acute Cervical Internal Carotid and Middle Cerebral Artery Occlusion: Video Case"],"prefix":"10.1227","volume":"85","author":[{"given":"Fucheng","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona"},{"name":"Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona"},{"name":"Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl R","family":"Abi-Aad","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona"},{"name":"Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona"},{"name":"Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard R","family":"Bendok","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona"},{"name":"Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona"},{"name":"Department of Radiology, Mayo Clinic, Phoenix, Arizona"},{"name":"Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona"},{"name":"Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandan","family":"Krishna","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona"},{"name":"Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona"},{"name":"Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,7]]},"reference":[{"issue":"3","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1161\/STR.0000000000000158","article-title":"2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"49","author":"Powers","year":"2018","journal-title":"Stroke"},{"issue":"1","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1706442","article-title":"Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct","volume":"378","author":"Nogueira","year":"2018","journal-title":"N Engl J Med"},{"issue":"8","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1056\/NEJMoa1713973","article-title":"Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging","volume":"378","author":"Albers","year":"2018","journal-title":"N Engl J Med"},{"issue":"2","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"e204","DOI":"10.1016\/j.crvasa.2016.02.006","article-title":"Stent or balloon: How to treat proximal internal carotid artery occlusion in the acute phase of ischemic stroke? Results of a short survey","volume":"58","author":"Widimsk\u00fd","year":"2016","journal-title":"Cor et Vasa."},{"issue":"3","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/neurintsurg-2014-011224","article-title":"Carotid stenting and intracranial thrombectomy for treatment of acute stroke due to tandem occlusions with aggressive antiplatelet therapy may be associated with a high incidence of intracranial hemorrhage","volume":"7","author":"Heck","year":"2015","journal-title":"J Neurointerv Surg"},{"issue":"9","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/ene.13633","article-title":"Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in patients with acute stroke with tandem lesion treated with thrombectomy: A collaborative pooled analysis","volume":"25","author":"Gory","year":"2018","journal-title":"Eur J Neurol."},{"issue":"13","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1016\/j.jcin.2018.05.036","article-title":"Carotid stenting with antithrombotic agents and intracranial thrombectomy leads to the highest recanalization rate in patients with acute stroke with tandem lesions","volume":"11","author":"Papanagiotou","year":"2018","journal-title":"JACC Cardiovasc Interv."},{"issue":"4","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1136\/practneurol-2017-001685","article-title":"Revolution in acute ischaemic stroke care: A practical guide to mechanical thrombectomy","volume":"17","author":"Evans","year":"2017","journal-title":"Pract Neurol"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006123-201907001-00018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:45:25Z","timestamp":1786121125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201907001-00018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,14]]},"references-count":8,"journal-issue":{"issue":"suppl_1","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyz084","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,14]]}}}