Fig. 1

A patient with symptomatic middle cerebral artery (MCA) occlusion underwent endovascular recanalization that led to successful recanalization. A-C: Preprocedural computed tomography angiography (CTA) volume rendering (VR) reconstruction (A) and maximal intensity projection (MIP; B and C) images showed an interrupted continuity in the M1 segment of the right MCA (white arrow). D and E: Multiple planar reconstruction (MPR) of CTA images showed the total luminal filling defect at the occluded segment of the MCA; the occlusion length was 6.5 mm. F: MPR of CTA images showed the occluded segment made a 15° turn from the proximal to the distal M1 segment. G-I: Digital subtraction angiography (DSA) confirmed occlusion of M1 segment of the right MCA (G), a tapered stump of the occluded segment (black arrow), and a slow antegrade flow through the occluded segment (TIMI grade 1) and visualization of the vascular bed at the distal end of the occlusion (black dovetail arrow), as well as retrograde blood flow (black dovetail arrowhead) from the anterior cerebral artery on the midarterial-phase (H) and late arterial-phase images (I). J: After successful navigation of the microwire and microcatheter through the occlusion, a 1.5 × 10 mm rapid-exchange balloon (Neuro LPS™, Sinomed, Tianjin, China) was positioned to the occluded segment (K), after which the lesion was predilated with 1.5 × 10 mm and 2.25 × 10 mm balloons and a 2.5 × 18 mm LEO baby stent was implanted. L: Postprocedural DSA demonstrated technically successful recanalization with TICI grade 3