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Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report

Received: 3 April 2025     Accepted: 14 April 2025     Published: 29 April 2025
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Abstract

Objective: Acute anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. Mechanical thrombectomy through the ipsilateral carotid artery can achieve recanalization in most acute occlusions of the anterior cerebral artery. However, ipsilateral carotid artery occlusion will significantly increase the difficulty and risk of thrombectomy of the anterior cerebral artery. Case presentation: A 50-year-old man presented with a sudden onset of right hemiparesis, dysarthria, and symptoms of confusion. Computed tomographic angiography revealed acute left ACA occlusion and chronic occlusion of the ipsilateral internal carotid artery. Thrombectomy of the ipsilateral anterior cerebral artery via the occluded internal carotid artery is both difficult and time-consuming. We performed thrombectomy of the left anterior cerebral artery through the right internal carotid artery via the anterior communicating artery. The target vessel was successfully recanalized and the patient achieved good results. There is no report about thrombectomy of contralateral anterior cerebral artery through the anterior communicating artery. Conclusion: This case prompt that it is feasible to use the anterior communicating artery as the thrombectomy path for the contralateral anterior cerebral artery distal medium vessel occlusion.

Published in Advances in Surgical Sciences (Volume 13, Issue 1)
DOI 10.11648/j.ass.20251301.12
Page(s) 5-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Acute Ischemic Stroke, Thrombectomy, Anterior Cerebral Artery, Anterior Communicating Artery, Case Report

References
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[2] Khalid Sawalha, Ahmed Abd Elazim, Omar Hussein. Ipsilateral Vocal Cord Paralysis After Acute Anterior Ischemic Stroke [J]. Perm J, 2020 Dec: 25: 1.
[3] A Filioglo, N Simaan, A Honig, M R Heldner, R von Rennenberg, A Pezzini, V Padjen, A Rentzos, V L Altersberger, P Baumgartner, A Zini, I Grisendi, S Aladdin, J M Gomori, S M Pilgram-Pastor, J F Scheitz,et al. Outcomes after reprfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration. [J] Neurol Sci 2022; 432: 120081.
[4] Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Maeda Kazushi, Yoshiaki Ikai, Hidefuku Gi. Mechanical Thrombectomy for Acute Anterior Cerebral Artery Occlusion. [J] World Neurosurg, 2018, 120: e957-e961.
[5] Campbell BC, Nguyen TN. Advances in stroke: treatments-interventional. [J] Stroke 2022; 53: 264–67.
[6] Padalino DJ, Deshaies EM. Tandem middle cerebral artery-internal carotid artery occlusions: reduced occlusion-to-revascularization time using a trans-anterior communicating artery approach with a penumbra device. [J] Neurosurg 2012; 116: 665–671.
[7] Jun Tsukano, Satoshi Kurabe, Tsutomu Sugai, Manabu Wada, Takashi Kumagai. Mechanical thrombectomy utilising a collateral pathway in a patient with dysgenesis of the internal carotid artery. Interv Neuroradiol. 2019 Feb; 25(1): 54–57.
[8] Duong Hoang Linh, Tran Chi Cuong, Nguyen-Luu Giang, Le Minh Thang, Nguyen Minh Duc. Cross-circulation thrombectomy for acute middle cerebral artery occlusion through a posterior communicating artery: a case report. AME Case Rep. 2023; 7: 27.
[9] Karen Cilliers, Benedict John Page, Review of the Anatomy of the Distal Anterior Cerebral Artery and Its Anomalies, Turk Neurosurg, 2016; 26(5): 653-61.
[10] Krishna Amuluru, Charles E Romero, Logan Pyle, Mohammad El-Ghanem, Fawaz Al-Mufti. Mechanical Thrombectomy of Acute Middle Cerebral Artery Occlusion Using Trans-Anterior Communicating Artery Approach, [J] World Neurosurg. 2018 Apr: 112: 46-52.
[11] George Triantafyllou, Răzvan Costin Tudose, Christos Tsiouris, George Tsakotos, Marios Loukas, R Shane Tubbs, Theodosis Kalamatianos, Christos Chrissicopoulos, Katerina Al-Nasraoui, Christos Koutserimpas, Mugurel Constantin Rusu, Konstantinos Natsis, Anastasios Kotrotsios, Maria Piagkou. The anterior communicating artery variants: a meta-analysis with a proposed classification system, [J] Surg Radiol Anat. 2024 May; 46(5): 697-716.
[12] Federico Bolognini, Pablo A Lebedinsky, Mariano Musacchio, Mariette Delaitre, Abdoulaye M Traoré, Francis Vuillemet, François Sellal, Jean-François Cerfon, Eric Schluck, Daniela Iancu, Elena A Cora, Sébastien Richard, René Anxionnat, Benjamin Gory, Stephanos N Finitsis. SOFIA catheter for direct aspiration of large vessel occlusion stroke: A single-center cohort and meta-analysis. [J] Interv Neuroradiol, 2021: 15910199211005328. Epub 2021 Apr 4.
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  • APA Style

    Ma, T., Xu, D. (2025). Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report. Advances in Surgical Sciences, 13(1), 5-10. https://doi.org/10.11648/j.ass.20251301.12

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    ACS Style

    Ma, T.; Xu, D. Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report. Adv. Surg. Sci. 2025, 13(1), 5-10. doi: 10.11648/j.ass.20251301.12

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    AMA Style

    Ma T, Xu D. Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report. Adv Surg Sci. 2025;13(1):5-10. doi: 10.11648/j.ass.20251301.12

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  • @article{10.11648/j.ass.20251301.12,
      author = {Tingjie Ma and Dong Xu},
      title = {Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report
    },
      journal = {Advances in Surgical Sciences},
      volume = {13},
      number = {1},
      pages = {5-10},
      doi = {10.11648/j.ass.20251301.12},
      url = {https://doi.org/10.11648/j.ass.20251301.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20251301.12},
      abstract = {Objective: Acute anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. Mechanical thrombectomy through the ipsilateral carotid artery can achieve recanalization in most acute occlusions of the anterior cerebral artery. However, ipsilateral carotid artery occlusion will significantly increase the difficulty and risk of thrombectomy of the anterior cerebral artery. Case presentation: A 50-year-old man presented with a sudden onset of right hemiparesis, dysarthria, and symptoms of confusion. Computed tomographic angiography revealed acute left ACA occlusion and chronic occlusion of the ipsilateral internal carotid artery. Thrombectomy of the ipsilateral anterior cerebral artery via the occluded internal carotid artery is both difficult and time-consuming. We performed thrombectomy of the left anterior cerebral artery through the right internal carotid artery via the anterior communicating artery. The target vessel was successfully recanalized and the patient achieved good results. There is no report about thrombectomy of contralateral anterior cerebral artery through the anterior communicating artery. Conclusion: This case prompt that it is feasible to use the anterior communicating artery as the thrombectomy path for the contralateral anterior cerebral artery distal medium vessel occlusion.
    },
     year = {2025}
    }
    

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    T1  - Thrombectomy of the Anterior Cerebral Artery Through a Trans-Anterior Communicating Artery Approach: A Case Report
    
    AU  - Tingjie Ma
    AU  - Dong Xu
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    N1  - https://doi.org/10.11648/j.ass.20251301.12
    DO  - 10.11648/j.ass.20251301.12
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
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    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20251301.12
    AB  - Objective: Acute anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. Mechanical thrombectomy through the ipsilateral carotid artery can achieve recanalization in most acute occlusions of the anterior cerebral artery. However, ipsilateral carotid artery occlusion will significantly increase the difficulty and risk of thrombectomy of the anterior cerebral artery. Case presentation: A 50-year-old man presented with a sudden onset of right hemiparesis, dysarthria, and symptoms of confusion. Computed tomographic angiography revealed acute left ACA occlusion and chronic occlusion of the ipsilateral internal carotid artery. Thrombectomy of the ipsilateral anterior cerebral artery via the occluded internal carotid artery is both difficult and time-consuming. We performed thrombectomy of the left anterior cerebral artery through the right internal carotid artery via the anterior communicating artery. The target vessel was successfully recanalized and the patient achieved good results. There is no report about thrombectomy of contralateral anterior cerebral artery through the anterior communicating artery. Conclusion: This case prompt that it is feasible to use the anterior communicating artery as the thrombectomy path for the contralateral anterior cerebral artery distal medium vessel occlusion.
    
    VL  - 13
    IS  - 1
    ER  - 

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Author Information
  • Department of Neurology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yin Chuan, China

  • Department of Neurology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yin Chuan, China

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