Case Report - Successful Thrombectomy After Critical Resuscitation Following a Cardiac Arrest

Area of Science:

• Neurology
• Cardiology
• Critical Care Medicine

Background:

• Limited evidence supports thrombectomy after periprocedural cardiac arrest or acute decompensation.
• Mechanical thrombectomy is a crucial treatment for acute ischemic stroke.

Purpose of the Study:

• To highlight a case where successful mechanical thrombectomy was achieved after a periprocedural cardiac arrest.
• To suggest reassessment of thrombectomy eligibility following critical care interventions.

Main Methods:

• Case report of a 23-year-old female with dilated cardiomyopathy presenting with left middle cerebral artery (MCA) stroke.
• Patient experienced cardiac arrest prior to planned thrombectomy.
• Successful resuscitation followed by repeat imaging and subsequent mechanical thrombectomy.

Main Results:

• Despite initial cardiac arrest and stroke presentation, the patient underwent successful mechanical thrombectomy.
• Repeat imaging confirmed a persistent perfusion deficit in the left MCA territory, indicating continued eligibility.
• Intensive care unit (ICU) resuscitation efforts were key to patient stabilization.

Conclusions:

• Aggressive critical care and resuscitation can enable successful mechanical thrombectomy even after periprocedural cardiac arrest.
• Patient eligibility for thrombectomy can be re-evaluated and achieved after stabilization in the ICU.
• This case expands the potential window for thrombectomy in complex stroke patients.