• Changchun Jiang, Yuechun Li, Fei Hao, Junfeng Yang, Baojun Wang, and Yu Fan.
• Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, China.
• Medicine (Baltimore). 2021 Mar 19; 100 (11): e24993e24993.

RationaleStent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization.Patient ConcernsA 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission.DiagnosesCerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA.InterventionsThrombectomy with 3 passes of the Solitaire FR device (Medtronic, Minneapolis, MN) was unsuccessful. Two stent retrievers were inserted in parallel by one microcatheter access point to each M2 branch, and then both stents were gradually retrieved out of the catheter while continuous suction was maintained.OutcomesAfter thrombectomy, subsequent follow-up angiograms showed mTICI 3 reperfusion of MCA. The patient has mRS 2 at discharge and the 3-month mRS score after stroke is 1 score.LessonsThe presented Y-configuration double-stent-retriever thrombectomy technique constitutes a safe and effective rescue treatment method for refractory thrombus in MCA bifurcation.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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