Neurointervention.  2014 Sep;9(2):101-105. 10.5469/neuroint.2014.9.2.101.

Forced Arterial Suction Thrombectomy of Septic Embolic Middle Cerebral Artery Occlusion Due to Infective Endocarditis: an Illustrative Case and Review of the Literature

Affiliations
  • 1Department of Neurology, Kyungpook National University Hospital, Daegu, Korea. yangha.hwang@gmail.com
  • 2Department of Radiology, Kyungpook National University Hospital, Daegu, Korea.
  • 3Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.
  • 4Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea.
  • 5School of Medicine, Kyungpook National University, Daegu, Korea.

Abstract

In acute ischemic stroke patients with major intracranial vessel occlusion due to infective endocarditis, treatment modalities are not well established. A 40-year-old woman presented with acute stroke due to left middle cerebral artery occlusion. She was successfully treated with intra-arterial mechanical thrombectomy, and the subsequent clinical outcome was favorable. Pathological analysis of the retrieved clots showed septic thrombi containing gram-positive cocci. Based on literature review and the present case regarding treatment strategies for patients with septic embolic stroke, pharmacological thrombolysis might increase the risk of hemorrhagic complications, which might alter clinical outcome. Therefore, we can consider intra-arterial mechanical thrombectomy as a first-line treatment option in patients with acute stroke resulting from infective endocarditis.

Keyword

Mechanical thrombectomy; Thrombolysis; Infective endocarditis; Acute ischemic stroke

MeSH Terms

Adult
Endocarditis*
Female
Gram-Positive Cocci
Humans
Infarction, Middle Cerebral Artery*
Stroke
Suction*
Thrombectomy*
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