Acute tandem occlusion stroke in internal carotid artery and fetal posterior cerebral artery: endovascular management.

INTRODUCTION: When the posterior cerebral artery arises from the internal carotid artery with an absent P1 segment, it is called fetal posterior cerebral artery (FPCA). It is unclear whether FPCA increases the risk of acute ischemic stroke, and the endovascular treatment of acute ischemic stroke due to acute occlusion of FPCA is not well established.

CASE REPORT: We report a case of acute ischemic stroke due to tandem occlusion of internal carotid artery and ipsilateral fetal posterior cerebral artery treated successfully with acute stenting of proximal lesion and mechanical thrombectomy of distal lesion with excellent neurological and functional outcomes.

CONCLUSION: Although further investigations are needed to determine the best treatment of these patients, endovascular treatment of fetal posterior cerebral artery occlusion is feasible.