FIG 2.

Illustrative case 2. A and B, This 81-year-old woman had acute left hemiparesis and dysarthria (initial NIHSS score = 8) secondary to an occlusion of the right M1 segment of the MCA, likely due to an underlying intracranial stenosis. Intravenous thrombolysis and endovascular treatment were performed. C, The first angiographic run confirms the pattern of intracranial acute thrombosis associated with an underlying stenosis (intracranial atherosclerosis). D, Considering the poor expected efficacy of a standard mechanical thrombectomy in such occlusion etiology, the limited infarct core, and the absence of intracranial hemorrhage at baseline, intracranial angioplasty and stent placement combined with cangrelor intravenous administration were performed as a first-line strategy. E and F, Clinical evolution and day 1 imaging have favorable results. At 90 days, the mRS score was 2.