{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:53:04Z","timestamp":1782867184507,"version":"3.54.5"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Retrieval of an atherosclerotic plaque\u2013vessel wall complex as a single specimen from the middle cerebral artery during mechanical thrombectomy (MT) is exceedingly rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 74-year-old man with atrial fibrillation underwent MT for right M1 occlusion. A red thrombus and a yellowish-white specimen were retrieved, and successful reperfusion was achieved. Histopathological examination of the retrieved specimen revealed an atherosclerotic plaque attached to the arterial wall, consistent with retrieval of the plaque\u2013vessel wall complex as a single specimen. Postoperatively, a subarachnoid hemorrhage was observed around the M2 inferior trunk, where vessel wall retrieval likely induced arterial dissection. Antithrombotic therapy and strict blood pressure control were implemented. Although progressive stenosis of the M2 inferior trunk was noted during follow-up, the vessel diameter eventually normalized without aneurysmal transformation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>MT with a stent retriever in vessels harboring atherosclerotic plaque may cause intracranial arterial dissection. Histopathological evaluation of retrieved specimens can help identify iatrogenic dissection. Appropriate selection of antithrombotic therapy, strict blood pressure control, and serial vascular imaging may help prevent progression of an intracranial hemorrhage.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26225\">https:\/\/thejns.org\/doi\/10.3171\/CASE26225<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26225","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:06:27Z","timestamp":1782864387000},"source":"Crossref","is-referenced-by-count":0,"title":["Retrieval of an atherosclerotic plaque\u2013vessel wall complex during mechanical thrombectomy: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Shohei","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5710-7456","authenticated-orcid":true,"given":"Hiroyuki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuki","family":"Akaike","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minami","family":"Uezato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Kinosada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-760X","authenticated-orcid":true,"given":"Yoshitaka","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10029","key":"bib1","series-title":"Lancet","first-page":"1723","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","unstructured":"Goyal MMenon BKvan Zwam WHEndovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. 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Clin Neurol Neurosurg. 2024;236:108070. doi:10.1016\/j.clineuro.2023.108070"},{"key":"bib21","series-title":"Front Neurol","first-page":"663058","article-title":"Subarachnoid hemorrhage in mechanical thrombectomy for acute ischemic stroke: analysis of the STRATIS registry, systematic review, and meta-analysis","volume":"12","author":"Lee","year":"2021","unstructured":"Lee HQureshi AMMueller-Kronast NHSubarachnoid hemorrhage in mechanical thrombectomy for acute ischemic stroke: analysis of the STRATIS registry, systematic review, and meta-analysis. Front Neurol. 2021;12:663058. doi:10.3389\/fneur.2021.663058"},{"issue":"6","key":"bib22","series-title":"Lancet Neurol","first-page":"640","article-title":"Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection","volume":"14","author":"Debette","year":"2015","unstructured":"Debette SCompter ALabeyrie MAEpidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection. Lancet Neurol. 2015;14(6):640-654. doi:10.1016\/S1474-4422(15)00009-5"},{"issue":"1","key":"bib23","series-title":"AJNR Am J Neuroradiol","first-page":"126","article-title":"One-year MR angiographic and clinical follow-up after intracranial mechanical thrombectomy using a stent retriever device","volume":"36","author":"Eug\u00e8ne","year":"2015","unstructured":"Eug\u00e8ne FGauvrit JYFerr\u00e9 JCOne-year MR angiographic and clinical follow-up after intracranial mechanical thrombectomy using a stent retriever device. AJNR Am J Neuroradiol. 2015;36(1):126-132. doi:10.3174\/ajnr.A4071"},{"issue":"2","key":"bib24","series-title":"Int J Stroke","first-page":"253","article-title":"Protocol for cilostazol stroke prevention study for antiplatelet combination (CSPS.com): a randomized, open-label, parallel-group trial","volume":"10","author":"Toyoda","year":"2015","unstructured":"Toyoda KUchiyama SHoshino HProtocol for cilostazol stroke prevention study for antiplatelet combination (CSPS.com): a randomized, open-label, parallel-group trial. 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