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Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery
INTRODUCTION: Acute ischemic stroke (AIS) can be a catastrophic complication of cardiac surgery previously without effective treatment. Endovascular thrombectomy (EVT) is a potentially life‐saving intervention. We examined patients at our institution who had EVT to treat AIS post cardiac surgery. ME...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10100038/ https://www.ncbi.nlm.nih.gov/pubmed/36335602 http://dx.doi.org/10.1111/jocs.17082 |
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author | Gupta, Aashray K. Sabab, Ahad Goh, Rudy Ovenden, Christopher D. Kovoor, Joshua G. Ramponi, Fabio Chan, Justin C. Y. Reddi, Benjamin A. J. Bennetts, Jayme S. Maddern, Guy J. Kleinig, Timothy J. |
author_facet | Gupta, Aashray K. Sabab, Ahad Goh, Rudy Ovenden, Christopher D. Kovoor, Joshua G. Ramponi, Fabio Chan, Justin C. Y. Reddi, Benjamin A. J. Bennetts, Jayme S. Maddern, Guy J. Kleinig, Timothy J. |
author_sort | Gupta, Aashray K. |
collection | PubMed |
description | INTRODUCTION: Acute ischemic stroke (AIS) can be a catastrophic complication of cardiac surgery previously without effective treatment. Endovascular thrombectomy (EVT) is a potentially life‐saving intervention. We examined patients at our institution who had EVT to treat AIS post cardiac surgery. METHODS: We retrospectively reviewed a stroke database from January 1, 2016 to October 31, 2021 to identify patients who had undergone EVT to treat AIS following cardiac surgery. Demographic data, operation type, stroke severity, imaging features, management and outcomes (mortality and modified Rankin Score (mRS)) were assessed. RESULTS: Of 5022 consecutive patients with AIS, 870 underwent EVT. Seven patients (0.8%) had EVT following cardiac surgery. Operations varied: two coronary artery bypass grafting (CABG), two transcatheter AVR, one redo surgical aortic valve replacement (AVR), one mitral valve repair and one patient with combined aortic and mitral valve replacements and CABG. Meantime postsurgery to stroke symptoms onset was 3 days (range 0–9 days). Median NIHSS was 26 (range 10–32). Five patients had middle cerebral artery occlusion and two internal carotid artery (n = 2). Median time between onset of symptoms and recanalization was 157 min (range 97–263). Two patients received Intra‐arterial Thrombolysis. All patients survived and were discharged to another hospital (n = 3), home (n = 2), or rehabilitation facility (n = 2). Median 3‐month mRS was 3 (range 0–6). CONCLUSION: We report the largest case series of EVT after cardiac surgery. EVT can be associated with excellent outcomes in these patients. Close neurological monitoring postoperatively to identify patients who may benefit from intervention is key. |
format | Online Article Text |
id | pubmed-10100038 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101000382023-04-14 Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery Gupta, Aashray K. Sabab, Ahad Goh, Rudy Ovenden, Christopher D. Kovoor, Joshua G. Ramponi, Fabio Chan, Justin C. Y. Reddi, Benjamin A. J. Bennetts, Jayme S. Maddern, Guy J. Kleinig, Timothy J. J Card Surg Regular Issue Papers INTRODUCTION: Acute ischemic stroke (AIS) can be a catastrophic complication of cardiac surgery previously without effective treatment. Endovascular thrombectomy (EVT) is a potentially life‐saving intervention. We examined patients at our institution who had EVT to treat AIS post cardiac surgery. METHODS: We retrospectively reviewed a stroke database from January 1, 2016 to October 31, 2021 to identify patients who had undergone EVT to treat AIS following cardiac surgery. Demographic data, operation type, stroke severity, imaging features, management and outcomes (mortality and modified Rankin Score (mRS)) were assessed. RESULTS: Of 5022 consecutive patients with AIS, 870 underwent EVT. Seven patients (0.8%) had EVT following cardiac surgery. Operations varied: two coronary artery bypass grafting (CABG), two transcatheter AVR, one redo surgical aortic valve replacement (AVR), one mitral valve repair and one patient with combined aortic and mitral valve replacements and CABG. Meantime postsurgery to stroke symptoms onset was 3 days (range 0–9 days). Median NIHSS was 26 (range 10–32). Five patients had middle cerebral artery occlusion and two internal carotid artery (n = 2). Median time between onset of symptoms and recanalization was 157 min (range 97–263). Two patients received Intra‐arterial Thrombolysis. All patients survived and were discharged to another hospital (n = 3), home (n = 2), or rehabilitation facility (n = 2). Median 3‐month mRS was 3 (range 0–6). CONCLUSION: We report the largest case series of EVT after cardiac surgery. EVT can be associated with excellent outcomes in these patients. Close neurological monitoring postoperatively to identify patients who may benefit from intervention is key. John Wiley and Sons Inc. 2022-11-06 2022-12 /pmc/articles/PMC10100038/ /pubmed/36335602 http://dx.doi.org/10.1111/jocs.17082 Text en © 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Regular Issue Papers Gupta, Aashray K. Sabab, Ahad Goh, Rudy Ovenden, Christopher D. Kovoor, Joshua G. Ramponi, Fabio Chan, Justin C. Y. Reddi, Benjamin A. J. Bennetts, Jayme S. Maddern, Guy J. Kleinig, Timothy J. Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title | Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title_full | Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title_fullStr | Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title_full_unstemmed | Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title_short | Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
title_sort | endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery |
topic | Regular Issue Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10100038/ https://www.ncbi.nlm.nih.gov/pubmed/36335602 http://dx.doi.org/10.1111/jocs.17082 |
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