Mechanical endovascular treatment of acute stroke due to cardiac myxoma

Abstract

In stroke secondary to cardiac myxoma, mechanical thrombectomy might represent a safe and effective treatment option. The authors suggest the use of histological examination of the clot for diagnosis as its composition may explain the differences in treatment outcome.

Mechanical thrombectomy for pediatric stroke arising from an atrial myxoma: case report

“…Only 1 case report describes mechanical thrombectomy in retrieval of clot secondary to atrial myxoma in an adult present- ing with left MCA syndrome. Similar to our case, GarciaPtacek et al 7 describe clot resistance requiring multiple passes for complete removal during thrombectomy. In addition, in the adult cases variability in success and subsequent clinical outcome have been described, further highlighting the unique complications posed by atrial myxoma emboli secondary to clot heterogeneity.…”

“…1,6 In addition, as seen during the thrombectomy of our patient, emboli secondary to atrial myxoma are particularly problematic due to their friable, gelatinous, and/or villous composition, which may impede optimal response to traditional embolic treatments. 7,14 While there are clear guidelines for the treatment of stroke in adults, several barriers have prevented the development of stroke guidelines in the pediatric population. Primarily, the low incidence of stroke in children delays diagnosis and prevents clinical trials that address effective treatment.…”

An Infrequent Type of Stroke with an Unusual Cause and Successful Therapy: Basilar Artery Occlusion Caused by a Cardiac Papillary Fibroelastoma Recanalized 12 Hours after Onset

“…In both cases, the strokes were in the anterior circulation. In addition, we found only one case involving the use of mechanical thrombolysis in the treatment of a stroke caused by a cardiac myxoma embolus (8).…”

Mechanical Endovascular Recanalization in a Patient with Middle Cerebral Artery Occlusion by Tumorous Emboli Originating from Cardiac Myxoma

“…Garcia et al 13) treated two cases with cardiac myxoma emboli by mechanical endovascular thrombectomy using Solitaire FR Device (Ev3, Plymouth, Minnesota, USA) and Trevo (Concentric Medical, Mountain View, California, USA). Although their retrieved emboli were thrombi, they speculated on the usefulness of the Merci Retriever (Concentric Medical, Mountain View, California, USA) for hard thrombus originating from such cardiac tumor.…”