Effectiveness of Mechanical Embolectomy for Septic Embolus in the Cerebral Artery Complicated with Infective Endocarditis

Kang, Gimoon; Yang, Tae Ki; Choi, Joon Hyouk; Heo, Sang Taek

doi:10.3346/jkms.2013.28.8.1244

Cited by 24 publications

(7 citation statements)

References 15 publications

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“…Also, about a half of the patients suffered intracerebral hemorrhage, which might be associated with the use of thrombolytics or pre-existing mycotic aneurysms [ 1 , 2 ]. On the contrary, the use of mechanical thrombectomy with or without adjuvant thrombolytics in such situations were reported in 7 cases, including the present case [ 3 , 4 , 5 , 10 , 11 , 12 ]. Interestingly, none of the reported cases showed any intracerebral hemorrhage, and the clinical outcome was good except in two cases (71%).…”

Section: Discussionmentioning

confidence: 68%

“…We reported successful recanalization with a favorable clinical outcome in a patient with acute ischemic stroke due to infective endocarditis, where the treatment was IA mechanical thrombectomy without any adjuvant thrombolytics. Table 1 summarized clinical and angiographic characteristics and outcomes of present and previous reported cases of acute ischemic stroke related to infective endocarditis based on treatment modalities [ 1 , 2 , 3 , 4 , 5 , 10 , 11 , 12 ]. The use of thrombolytic agents only in such situations were reported in 8 cases in the literature [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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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.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…We performed a review of the existing literature and found another 13 case reports of successful mechanical thrombectomy after septic embolization of the MCA. [8][9][10][11][12][13][14][15][16][17] The clinical characteristics and outcomes of these patients are shown in Table 1. While no patient received intravenous thrombolysis, in four patients (31%), rt-Pa was given intraarterially.…”

Section: Discussionmentioning

confidence: 99%

Successful thrombectomy in endocarditis-related stroke: Case report and review of the literature

2018

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Neurological complications of infective endocarditis are frequent, especially ischaemic strokes. As intravenous thrombolysis in infective endocarditis-related ischaemic stroke has a controversial benefit/risk ratio, alternative treatment regimens have to be considered. We present the case of a young patient with septic embolism of the middle cerebral artery who was successfully treated with mechanical thrombectomy, and give a short review of the existing literature.

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“…The database search yielded 431 relevant records published until January 2020. Nineteen articles fulfilled the eligibility criteria [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Three articles (16%) were case series while sixteen (84%) were single case report.…”

Section: Resultsmentioning

confidence: 99%

Endovascular treatment of ischemic large-vessel stroke due to infective endocarditis: case series and review of the literature

D’Anna

2020

Neurol Sci

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Background Mechanical thrombectomy is the standard of care, in selected patients, for acute ischemic stroke with large vessel occlusion but its use in patients with stroke secondary to infective endocarditis is controversial. We report three cases of acute ischemic stroke treated by mechanical thrombectomy and we propose an extensive review of the literature to evaluate the clinical safety and efficacy of thrombectomy in patients with stroke secondary to infective endocarditis. Methods A comprehensive literature search was performed following a pre-specified protocol of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Case reports, cases series, cross-sectional studies, case control studies, randomized controlled trials or nonrandomized controlled trials were considered that included endocarditis-related acute ischemic stroke patients who underwent mechanical thrombectomy. Results The database search yielded 431 relevant records published until January 2020. Nineteen articles fulfilled the eligibility criteria that described thirty patients. After the thrombectomy, 13.3% of the patients experienced intracranial haemorrhage. After the procedure, the median National Institutes of Health Stroke Scale score dropped from 15 (IQR 7) to 2.5 (IQR 5.75). At 90 days, mortality was 23.3% while 46.7% of the patients were functionally independent (mRS ≤ 2). Discussion Based on our review, the use of mechanical thrombectomy in patients with large vessel occlusion due to endocarditisassociated stroke might improve patient outcome but it should be considered on a case by case base as the safety has not been well established yet. Further research on risk stratification is needed to drive clinician during the decision-making process.

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Effectiveness of Mechanical Embolectomy for Septic Embolus in the Cerebral Artery Complicated with Infective Endocarditis

Cited by 24 publications

References 15 publications

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

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

Successful thrombectomy in endocarditis-related stroke: Case report and review of the literature

Endovascular treatment of ischemic large-vessel stroke due to infective endocarditis: case series and review of the literature

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