We report the first published case of a mechanical thrombectomy for acute ischemic stroke via radial access in a patient with status post recent frozen elephant trunk graft (FET) for aortic arch repair. A 69 year-old male presented with a left middle cerebral artery large vessel occlusion two weeks after FET graft repair. After consultation with the patient’s cardiothoracic surgeon, a radial approach was deemed safest to access the left-sided large vessel occlusion. The FET procedure is a hybrid open and endovascular repair of aortic arch and descending aortic aneurysm and dissection repair. A vascular graft is used to reconstruct the transverse aortic and great vessel anastomoses. Then, a stent graft is deployed in the descending aorta which is then sewn to the vascular graft. This allows for a single operation in lieu of multistage arch repairs. As FET is becoming an increasingly common procedure among cardiothoracic surgeons, it is important for the neurointerventionalist to be aware of such anatomy when treating an acute thrombectomy patient. Although direct carotid puncture is feasible, given the multiple blood thinners and antiplatelets these patients are on, pursuing alternative options can be beneficial to such patients. We describe successful recanalization with excellent postoperative functional return (mRs 2 at 90 days) with mechanical thrombectomy via radial approach.

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Abstract E-242 Figure 1

Disclosures T. Chaudhry: None. M. Potts: None.