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Mechanical Thrombectomy for Methamphetamine-Associated Cardiomyopathy with Left Ventricular Thrombus: A Case Report

Tomohiro Fujioka1, Kyoko Higashida1, Naoki Hatayama1

  • 1Department of Neurology, Osaka General Medical Center, Osaka, Osaka, Japan.

Journal of Neuroendovascular Therapy
|May 14, 2025
PubMed
Abstract

Insights

Methamphetamine-associated cardiomyopathy (MACM) increases stroke risk. A patient with MACM experienced a stroke during heart failure treatment, requiring mechanical thrombectomy for recovery.

Area of Science:

  • Cardiology
  • Neurology
  • Toxicology

Background:

  • Methamphetamine abuse is rising globally, leading to increased cases of methamphetamine-associated cardiomyopathy (MACM).
  • MACM frequently presents with left ventricular thrombosis, a significant risk factor for cardioembolic stroke.

Observation:

  • A 54-year-old male with a 30-year history of methamphetamine abuse developed acute heart failure due to MACM with a left ventricular thrombus.
  • During hospitalization for heart failure, the patient suffered an acute ischemic stroke, manifesting as aphasia and hemiparesis.
  • Cerebral MRI confirmed ischemic changes in the left cerebral hemisphere.

Findings:

  • The patient underwent successful mechanical thrombectomy for left internal carotid artery occlusion, achieving complete reperfusion.
  • Post-thrombectomy, the patient experienced persistent ipsilateral cerebral hyperemia for 30 days.
  • Neurological deficits, including moderate aphasia and mild right upper limb paralysis, persisted at 90 days, with a modified Rankin Scale score of 3.

Implications:

  • This case highlights the critical risk of stroke in MACM patients, even during acute heart failure management.
  • Mechanical thrombectomy is a viable treatment for acute ischemic stroke in MACM patients.
  • Left ventricular thrombosis in MACM necessitates vigilant monitoring and prophylactic strategies against cardioembolic events.
Keywords:
acute ischemic strokecerebral hyperperfusion syndromemechanical thrombectomymethamphetamine-associated cardiomyopathy

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