Vessel wall enhancement by gadolinium-enhanced MRI in a patient with delayed stenosis after mechanical thrombectomy

Description 

Delayed stenosis of targeted vessels is a reported complication of stent retriever-based mechanical thrombectomy.1 We report a case of delayed stenosis with MRI findings that may be related to the underlying stenotic mechanism.

A 46-year-old woman was brought to our hospital with sudden left hemiparesis and unilateral spatial neglect. MRI revealed occlusion of the right middle cerebral artery (MCA) and acute cerebral infarction (figure 1A,B). Emergent mechanical thrombectomy was performed with one stent retriever pass following two aspiration catheter passes, and a red thrombus was retrieved (figure 1C,D). We thought that an embolism had caused the vessel occlusion as no abnormalities were visualised at the occluded site on day 2 (figure 1E). Despite detailed examinations, we could not determine the embolic source during the patient's hospitalisation, so we administered low-dose aspirin. She was discharged on day 46.

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