Endovascular mechanical thrombectomy is an effective, well tolerated treatment alternative for patients with emergent stroke syndromes after distal anterior and posterior intracranial thrombo-embolism.

Background Endovascular mechanical thrombectomy has been proven to be an effective and safe treatment strategy for emergent large vessel occlusion. However, the effectiveness and safety of this technique has not been well established for more distal, smaller vessels. In our series, we demonstrate technical success using various described revascularization techniques for ACA, PCA and distal MCA branches. Intervention results in significant clinical improvement with no significant increase in complications.

Methods Forty-one consecutive patients who presented with occlusions of either ACA, PCA or distal MCA branches were retrospectively reviewed. A comprehensive description of the affected stroke territories, post revascularization mTICI outcomes as well as the pertinent devices are presented and discussed.

Results In our series of 41 patients with emergent small vessel occlusions of the anterior and posterior circulation, 6 ACA and 3 PCA branches occlusions are described. Age on admission was distributed as 68 ±16 years (mean ± SD), and approximately 51% were male. mTICI revascularization was possible in 41% with at least 50% recanalization in 93%.

Conclusions Mechanical revascularization for emergent small vessel occlusions is a viable intervention alternative with minimal post procedural risk profiles in patients.

Disclosures K. Carr: None. Z. Thwing: None. R. Shivashankar: None. Y. Serulle: None.