56 years Male (DOB:3/23/1960)Reason: L MCA syndrome History: R hemianopsia, L gaze, R face/arm/leg weakness, aphasia NIH SSS = 22PROVIDER/ATTENDING NAME: DAVID A HARTER AGNIESZKA A ARDELTFLUOROSCOPY TIME: 9.1 minutesFrontal: 829.64 mGyLateral: 704.73 mGyOPERATORS: Greg Christoforidis Left common carotid artery: There is no evidence for carotid stenosis on the basis of NASCET criteria. There is no evidence for carotid dissectionLeft internal carotid arteryThere is opacification of the left anterior cerebral artery and partial opacification of the left posterior cerebral artery. There is occlusion of the left middle cerebral artery at its origin associated with grade 2 leptomeningeal collaterals. There are foci of stenosis along the left pericallosal artery.Intraprocedural arteriograms:There is progressive recanalization of the left middle cerebral artery.Left internal carotid artery following the procedure:There is recanalization of the left middle cerebral artery including superior and inferior divisions with some slow flow in some of the distal M5 branches ..There are multiple foci of stenosis and narrowing of branches of the MCA and ACARight common iliac artery: No contraindication to closure device.
1.Left middle cerebral artery occlusion at its origin.2.Embolectomy with TIMI 3 recanalization and TICI 3 reperfusion of the left middle cerebral artery using the Trevo embolectomy device.3.Intracranial atherosclerotic disease involving distal branches.4.Findings were discussed with Dr Ardelt at the end of the procedure.