Mechanical thrombectomy for acute stroke complicating cardiac interventions

Area of Science:

• Neurology
• Cardiology
• Interventional Radiology

Background:

• Acute ischemic stroke (AIS) can complicate cardiac interventions (CI).
• Mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) in this context is underreported.

Purpose of the Study:

• To investigate the outcomes of MT for AIS with ELVO following recent CI.

Main Methods:

• Retrospective review of nine patients undergoing MT for AIS with ELVO after CI.
• Data collected included demographics, CI type, stroke characteristics, neurovascular intervention, and outcomes.

Main Results:

• Nine patients (mean age 67, mostly male, with arrhythmia) underwent MT post-CI (most commonly CABG).
• Presenting NIHSS was 18, with MCA occlusions in seven cases; successful recanalization achieved in most.
• Despite initial improvement, 7/9 patients had poor functional outcomes (mRS 4-6), with 3 mortalities.

Conclusions:

• AIS with ELVO post-CI is linked to high mortality and poor functional outcomes, even with MT.
• Further investigation is required to understand the drivers of poor outcomes in this subgroup.