Erschienen in:
01.06.2003 | Case Report
Endovascular Mechanical Thrombectomy of an Occluded Superior
Division Branch of the Left MCA for Acute Cardioembolic
Stroke
verfasst von:
H. C. Schumacher, P. M. Meyers, D. R. Yavagal, N. Y. Harel, M. S. V. Elkind, J. P. Mohr, J. Pile-Spellman
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 3/2003
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Abstract
Cardiac embolism accounts for a large proportion
of ischemic stroke. Revascularization using systemic or intra-arterial
thrombolysis is associated with increasing risks of cerebral hemorrhage
as time passes from stroke onset. We report successful mechanical
thrombectomy from a distal branch of the middle cerebral artery (MCA)
using a novel technique. A 72-year old man suffered an acute ischemic
stroke from an echocardiographically proven ventricular thrombus due to
a recent myocardial infarction. Intra-arterial administration of 4 mg
rt-PA initiated at 5.7 hours post-ictus failed to recanalize an
occluded superior division branch of the left MCA. At 6 hours,
symptomatic embolic occlusion persisted. Mechanical extraction of the
clot using an Attracter-18 device (Target Therapeutics, Freemont, CA)
resulted in immediate recanalization of the MCA branch. Attracter-18
for acute occlusion of MCA branches may be considered in selected
patients who fail conventional thrombolysis or are nearing closure of
the therapeutic window for use of thrombolytic agents.