Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2019
Mechanical Thrombectomy in Stroke from Infective Endocarditis: Case Report and Review.
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Sloane Kelly L, Raymond Scott B, Rabinov James D, Singhal Aneesh B
Аннотация
OBJECTIVE: To characterize outcomes after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) from infective endocarditis.
METHODS: Case report and review of published cases.
RESULTS: We report the case of a 59-year-old woman with fungal endocarditis who developed AIS from a proximal middle cerebral artery (MCA) embolus. She underwent MT, with good outcome. An additional 25 similar cases were identified from 14 publications. Among the 26 cases analyzed (mean [SD] age, 55 [18.7] years, 42% women), the MCA was the most common site of arterial occlusion. Four patients received intravenous tissue plasminogen activator treatment before MT. The median admission NIH Stroke Scale score (NIHSSS) was 15.5 [interquartile range 9.75-19.25] and the median post-procedure NIHSSS was 2 [interquartile range .75-6]. No patient developed symptomatic intracerebral hemorrhage.
CONCLUSIONS: MT appears to be a safe and effective therapeutic option in infective endocarditis-related AIS with proximal-artery occlusion.
METHODS: Case report and review of published cases.
RESULTS: We report the case of a 59-year-old woman with fungal endocarditis who developed AIS from a proximal middle cerebral artery (MCA) embolus. She underwent MT, with good outcome. An additional 25 similar cases were identified from 14 publications. Among the 26 cases analyzed (mean [SD] age, 55 [18.7] years, 42% women), the MCA was the most common site of arterial occlusion. Four patients received intravenous tissue plasminogen activator treatment before MT. The median admission NIH Stroke Scale score (NIHSSS) was 15.5 [interquartile range 9.75-19.25] and the median post-procedure NIHSSS was 2 [interquartile range .75-6]. No patient developed symptomatic intracerebral hemorrhage.
CONCLUSIONS: MT appears to be a safe and effective therapeutic option in infective endocarditis-related AIS with proximal-artery occlusion.