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Mechanical Thrombectomy for Postoperative Stroke in a Patient with Acute Aortic Dissection Type A

Mechanical thrombectomy has been proposed to expand the treatment time window and enhance revascularization. However, it is unclear whether its use can be extended to patients with occlusions in acute aortic dissection, especially the thoracic aorta. A 55-year-old man underwent graft replacement for...

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Detalles Bibliográficos
Autores principales: Kehara, Hiromu, Urashita, Syuichi, Gomibuchi, Toshihito, Komatsu, Kazunori, Takahashi, Kouhei, Tsukioka, Katsuaki, Terasaki, Takamitsu, Kono, Tetsuya, Wada, Naomichi, Kakizawa, Yukinari, Koyama, Jun-ichi, Okada, Kenji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162810/
https://www.ncbi.nlm.nih.gov/pubmed/32322455
http://dx.doi.org/10.2176/nmccrj.cr.2019-0134
Descripción
Sumario:Mechanical thrombectomy has been proposed to expand the treatment time window and enhance revascularization. However, it is unclear whether its use can be extended to patients with occlusions in acute aortic dissection, especially the thoracic aorta. A 55-year-old man underwent graft replacement for acute aortic dissection type A. On postoperative day 2, he developed stroke and computed tomography showed occlusion of the right middle cerebral artery. Mechanical thrombectomy was performed by transbrachial approach. Although successful recanalization was achieved, he suffered hemorrhagic stroke. Since there is no other effective treatment and the neurologic outcome with conservative management is poor, we consider mechanical thrombectomy to be a viable therapeutic option for the treatment of postoperative stroke in patients with acute aortic dissection type A. However, further study is warranted regarding the safety of this technique.