Data from randomized clinical trials and current guidelines suggest that patients
with anterior circulation occlusion with contraindications to intravenous thrombolysis
may benefit from direct mechanical thrombectomy. Nevertheless, no data are available
on the efficacy and safety of direct mechanical thrombectomy in patients with concomitant
spontaneous intracerebral hemorrhage. We report the case of a 51-year-old woman with
a spontaneous intracerebral hemorrhage in the right parietal and occipital lobes,
who experienced, 7 days later, an occlusion of the proximal left middle cerebral artery.
Direct mechanical thrombectomy was performed, with complete recanalization of the
left middle cerebral artery and good clinical outcome. To our knowledge, this is the
first case report of direct mechanical thrombectomy for acute ischemic stroke in the
setting of concomitant spontaneous intracerebral hemorrhage in a different vascular
territory.
Key Words
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References
- Intravenous thrombolysis and intra-arterial interventions in acute ischemic stroke: Italian Stroke Organisation (ISO)-SPREAD guidelines.Int J Stroke. 2015; 10: 1119-1129
- Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke. 1993; 24: 35-41
- Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials.Lancet. 2016; 387: 1723-1731
- 2015 American Heart Association/American Stroke Association Focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2015; 46: 3020-3035
Article info
Publication history
Published online: May 17, 2017
Accepted:
April 21,
2017
Received in revised form:
March 23,
2017
Received:
December 28,
2016
Footnotes
Conflict of interest: The authors declare that they have no conflict of interest.
Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent: Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.04.024
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
