Acute Treatment of Ischemic Stroke Caused by Stent Graft Thrombosis After Thoracic Endovascular Aortic Repair.

Autor:	Saito T; Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Saito T; Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Ishii T; Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Homma K; Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Kunii Y; Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Koide M; Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN., Ohashi T; Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu City, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 13; Vol. 16 (7), pp. e64465. Date of Electronic Publication: 2024 Jul 13 (Print Publication: 2024).
DOI:	10.7759/cureus.64465
Abstrakt:	Planning for the acute phase of ischemic stroke in postoperative patients with aortic dissection is difficult from the perspective of concerns about worsening disease related to aortic dissection due to intravenous thrombolytic agents and securing access routes when mechanical thrombectomy is planned. Herein, we report that a 52-year-old man underwent thoracic endovascular aortic repair for acute type B aortic dissection. One year after the procedure, the patient developed a stroke caused by stent graft thrombosis, and computed tomography angiography showed occlusion of the left common carotid artery and left internal carotid artery. Stroke neurologists performed mechanical thrombectomy via a direct approach from the left common carotid artery, and successful recanalization was achieved. Furthermore, ligation of the proximal portion of the left common carotid artery and bypass surgery on the distal portion of the left common carotid artery were performed by cardiovascular surgeons. Although the patient had a postoperative hemorrhagic infarction, he returned to work without a recurrence of stroke after two years of follow-up. A direct carotid artery puncture we performed is an alternative in cases of anatomical difficulty or an unfavorable aortic arch. This case highlights not only the significance of interdisciplinary collaboration between cardiac and neurological specialists but also the impact of training dual-specialty cerebrovascular neurosurgeons on patient outcomes. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Saito et al.)
Databáze:	MEDLINE
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