Reocclusion of the treated vessel due to endothelial injury after mechanical thrombectomy in a patient with acute ischaemic stroke
| Autor: | Masaoki Hidaka, Yuya Koyanagi, Shinya Yamaguchi, Shuji Arakawa |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Reoperation
0301 basic medicine Middle Cerebral Artery medicine.medical_specialty Cerebral arteries Dissection (medical) Global aphasia 030105 genetics & heredity Tissue plasminogen activator Brain Ischemia 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Recurrence Internal medicine Atrial Fibrillation Occlusion medicine Humans Ozagrel Thrombectomy Aged 80 and over medicine.diagnostic_test business.industry Endovascular Procedures Infarction Middle Cerebral Artery Atrial fibrillation General Medicine medicine.disease Reminder of Important Clinical Lesson Cerebral Angiography Treatment Outcome Angiography Cardiology Methacrylates Female business Magnetic Resonance Angiography 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2018-228937 |
| Popis: | A 92-year-old woman developed sudden consciousness disturbance, global aphasia and right hemiparesis. She had atrial fibrillation and cardioembolic stroke was diagnosed. Tissue plasminogen activator was administered, and endovascular treatment was initiated. The left middle cerebral artery was occluded and complete recanalisation was achieved after direct aspiration first-pass technique. However, MRI immediately after treatment showed reocclusion. Endovascular treatment was repeated and complete recanalisation was achieved. There was no evidence of cerebral artery dissection, but angiography soon after the second procedure revealed early reocclusion. Ozagrel, an antiplatelet agent, was administered intravenously and prevented reocclusion. Endothelial injury was speculated to have occurred during the first mechanical thrombectomy, leading to recurrent occlusion. Though the patient continued to have right hemiparesis, she recovered from her consciousness disturbance and aphasia after re-treatment. |
| Databáze: | OpenAIRE |
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