Intravenous Thrombolysis and Three Mechanical Thrombectomies in 15 Days in a Patient with Carotid Web: a Case Report

We report the case of a woman with acute ischemic stroke due to recurrent occlusion of the left middle cerebral artery, which occurred three times in 15 days. Only after the third event, digital subtraction angiography detected carotid web (CW) in the left internal carotid artery. Management of CW is still debated and varies from medical therapy to endovascular and surgical approaches, in order to avoid recurrences and outcome worsening. Early arterial reocclusion is associated with poor outcome compared with persistent recanalization. According to the current data, repeated endovascular treatment appears to be a viable option for recurrences and should not be withheld. Intravenous thrombolysis, three mechanical thrombectomies, and stent placing were needed to ensure good outcome in our patient.