Skip to main content
main-content

31.07.2018 | Original Article - Vascular Neurosurgery - Ischemia | Ausgabe 9/2018

Acta Neurochirurgica 9/2018

Long-term outcomes following thrombectomy for acute ischemic stroke in patients with a left ventricular assist device: a case series and literature review

Zeitschrift:
Acta Neurochirurgica > Ausgabe 9/2018
Autoren:
Bikei Ryu, Tatsuya Ishikawa, Koji Yamaguchi, Go Matsuoka, Seiichiro Eguchi, Takakazu Kawamata
Wichtige Hinweise
This article is part of the Topical Collection on Vascular Neurosurgery - Ischemia

Abstract

Background

Left ventricular assist devices (LVADs) were developed for the treatment of patients with severe heart failure (HF) as a bridge to heart transplantation (HT). Although long-term LVAD support results in substantial improvements, their long-term use often leads to severe acute ischemic stroke (AIS). Serious neurological events make it difficult to continue LVAD support, and these patients are excluded as candidates for HT. AIS remains a challenging problem in patients receiving LVAD support. Recently, although thrombectomy has been established in selected patients who are independent, it has not been established in patients who are not completely independent, such as those with LVAD support.

Methods

We describe four AIS patients with severe HF who were implanted with an LVAD as a bridge to HT. Five mechanical thrombectomies were performed for AIS associated with an LVAD in four patients. A literature review is presented and compared to the present results.

Results

Good recanalization was achieved in all patients. In three cases, marked neurological improvement was observed, and modified Rankin Scale (mRS) scores were maintained without deterioration. The median total follow-up period was 592 days. In one patient, HT was successfully performed after thrombectomy. Currently, two of the patients without neurological deficits are awaiting HT.

Conclusions

Embolism is a major problem encountered by patients under LVAD support while waiting for an HT. Thrombectomy for AIS associated with LVAD support is a useful and safe treatment modality. It is possible to maintain a reasonable mRS score in patients who are not completely independent.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 9/2018

Acta Neurochirurgica 9/2018 Zur Ausgabe

Letter to the Editor - Infection

Bone resorption around anular closure device

Original Article - Vascular Neurosurgery - Aneurysm

Loop microcatheter technique for coil embolization of paraclinoid aneurysms

  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

  2. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

  3. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise