Stent-Retriever Thrombectomy Across Circle of Willis.

Abstract

Endovascular thrombectomy has become the gold standard for acute ischemic stroke intervention in appropriate patients. Occasionally, thrombectomy through the standard craniocervical artery related to the affected territory is not technically feasible due to patient-specific anatomic issues. This is a retrospective review of cases where intracranial access was achieved via an unaffected circulation across the Circle of Willis. A technically successful thrombectomy is described in detail in 3 cases along with technical challenges encountered. Thrombectomy across the Circle of Willis is a potential bailout technique for select, complex cases. Further investigation is warranted.