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Case report
Where did the clot go? An unusual complication of mechanical thrombectomy caused by malignancy related subclavian steal phenomenon in a patient with acute basilar artery occlusion
  1. Nikkie Randhawa1,
  2. Jonathan P Squires2,
  3. Manraj Kanwal Singh Heran3,
  4. Sharanpal K Mann2
  1. 1Department of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
  1. Correspondence to Dr N Randhawa, Department of Neurology, University of British Columbia, Vancouver, British Columbia, Canada V5Z 1M9; nikkierandhawa{at}gmail.com

Abstract

Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically.

  • Complication
  • Embolic
  • Intervention
  • Stroke
  • Thrombectomy

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Footnotes

  • Republished with permission from BMJ Case Reports Published 25 October 2016; doi:10.1136/bcr-2016-012665

  • Contributors NR was the primary author of the paper. JS was a contributing author to the manuscript. MH was a contributing author and responsible for revisions and image selection. SM was a contributing author and responsible for manuscript revisions.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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