Objective: To report a patient who achieved complete recanalization using the parallel stent retriever (SR) technique for a refractory acute middle cerebral artery (MCA) embolism.
Case presentation: An 86-year-old woman underwent an emergency thrombectomy for acute right MCA occlusion. Although thrombectomy has been attempted three times with the conventional technique using a single SR, no recanalization was achieved. Then, an innovative technique was used to deploy two SRs in parallel with the M1 segment of the MCA. Pulling them back simultaneously, the thrombus was retrieved, and complete recanalization was achieved.
Conclusion: The parallel SR technique is a feasible method and can be considered as one of the last treatment resorts for acute refractory embolisms at the major MCA trunk.
Keywords: acute ischemic stroke; mechanical thrombectomy; stent retriever.
©2020 The Japanese Society for Neuroendovascular Therapy.