Internal Carotid Artery Injury due to Aspiration Technique from Balloon Guide Catheter on Acute Thrombectomy: A Case Report

Abstract

Objective: Acute large vessel occlusion is treated with endovascular thrombectomy. We encountered a patient in whom the internal carotid artery (ICA) was injured by direct aspiration through a balloon guide catheter (BGC). Case Presentation: The patient was an 82-year-old woman being treated with oral warfarin for atrial fibrillation. Endovascular thrombectomy was performed for right ICA occlusion presented with left hemiplegia when direct aspiration was applied through BGC which placed into the right ICA, extravasation was noted on imaging immediately after its application. Hemostasis was acquired by coil embolization, but extensive subarachnoid hemorrhage was noted on postoperative CT and the patient died after 3 days. Conclusion: The direct aspiration technique through BGC should be carefully performed because it may have a risk of vascular injury.