Mechanical Thrombectomy in Stroke from Infective Endocarditis: Case Report and Review

To characterize outcomes after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) from infective endocarditis.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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This study investigated differences in long-term outcomes between SAVR-treated patients more than 70 years of age who received mechanical or biologic prosthetic valves.MethodsAll patients (excluding those with endocarditis) who were more than 70 years of age and who underwent isolated first-time SAVR (with or without coronary artery bypass grafting) in Finland between 2004 and 2014 were retrospectively studied (n = 4227). Propensity score matching (1:3) was used to account for baseline differences (n = 296 with mechanical prostheses and n = 888 with biologic prostheses). Outcomes were 10-year survival, major...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Ischemic stroke is one of the most common complications of infective endocarditis (IE). IE must be considered as one of the causes of acute ischemic stroke (AIS) with emergent large vessel occlusion (ELVO), but early diagnosis of IE is difficult. AIS with ELVO must be treated using endovascular thrombectomy (EVT), with or without intravenous thrombolysis (IVT). IVT for AIS due to IE is not well established and remains controversial because of the risk of intracranial hemorrhage. A 42-year-old man suffered from right hemiparesis and disorientation, and AIS with ELVO was diagnosed.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Objectives: To evaluate the safety of acute ischemic stroke (AIS) therapy in patients with infective endocarditis (IE) with intravenous thrombolysis (IVT) or endovascular therapy (EVT) such as mechanical thrombectomy. Methods: We conducted a retrospective study of patients who underwent AIS therapy with IVT or EVT at a tertiary referral center from 2013 to 2017, that were later diagnosed with acute IE as the causative mechanism. We then performed a systematic review of reports of acute ischemic reperfusion therapy in IE since 1995 for their success rates in terms of neurological outcome, and mortality, and their risk of he...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Publication date: Available online 10 May 2019Source: The Annals of Thoracic SurgeryAuthor(s): Ville Kytö, Monna E. Myllykangas, Jussi Sipilä, Teemu J. Niiranen, Päivi Rautava, Jarmo GunnAbstractBackgroundBiological prostheses are preferred for surgical aortic valve replacement (SAVR) in patients aged>70 years in clinical practice. We studied differences in long-term outcomes between SAVR patients aged>70 years who received mechanical and biological prosthetic valves.MethodsAll patients (excluding endocarditis) aged>70 years with isolated first-time SAVR (±coronary artery by-pass grafting) in...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Long-term outcomes with mechanical versus biological aortic valve prosthesis in patients>70 years. Ann Thorac Surg. 2019 May 10;: Authors: Kytö V, Myllykangas ME, Sipilä J, Niiranen TJ, Rautava P, Gunn J Abstract BACKGROUND: Biological prostheses are preferred for surgical aortic valve replacement (SAVR) in patients aged>70 years in clinical practice. We studied differences in long-term outcomes between SAVR patients aged>70 years who received mechanical and biological prosthetic valves. METHODS: All patients (excluding endocarditis) aged>70 years with isolated first-time SA...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
We report a case of an acute ischemic stroke treated by mechanical thrombectomy, with the histopathological analysis of the retrieved clot followed by the confirmation of fungal endocarditis. An extensive review of the literature has been proposed and three key points concerning the fungal endocarditis predisposing factors, the relation between thrombolysis and hemorrhagic risk and, finally, the importance of clot analysis have been discussed.
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
CONCLUSION: Detailed morphological and histopathological analysis of EVT-retrieved clots including Gram staining can assist in etiological classification of the clot. Understanding the composition of the clot may be of clinical value in early diagnostics and mapping treatment planning in IE. PMID: 30867075 [PubMed - as supplied by publisher]
Source: The Canadian Journal of Neurological Sciences - Category: Neurology Authors: Tags: Can J Neurol Sci Source Type: research
For the sake of completeness the risk factors enumerated by Wanget al. for haemorrhagic transformation of acute cerebral infarcts after intravenous thrombolysis (IVT)1 ought to include infective endocarditis (IE)-related septic emboli.2 In the latter study, which covered the period 2002 –10, 222 patients (mean age 69; 46% female) were identified who were treated with IVT for acute ischaemic stroke associated with IE. These patients were compared with 134 048 counterparts (mean age 69; 49% female) treated with IVT in the absence of IE. The rate of IVT-related intracerebral haemorr hage was significantly (P =&th...
Source: QJM - Category: Internal Medicine Source Type: research
We appreciate the opportunity to respond to Dr. Jolobe ’s letter titled ‘Septic cerebral emboli as a risk factor for thrombolysis-related hemorrhagic transformation’. Dr. Jolobe made a nice comment on our article titled ‘Risk factors of hemorrhagic transformation after intravenous thrombolysis with rt-PA in acute cerebral infarction’.1 We agree that septic cerebral emboli was a risk factor for thrombolysis-related hemorrhagic transformation as demonstrated in an early study.2 In fact, it was based on this early study and the following studies that intravenous thrombolysis is not recommended fo...
Source: QJM - Category: Internal Medicine Source Type: research
Publication date: January 2019Source: Archives of Cardiovascular Diseases Supplements, Volume 11, Issue 1Author(s): G. Charbonnier, Y. Lavie-Badie, G. Robin, F. Labaste, D. Eyharts, P. Fournier, E. Cariou, L. Porte, B. Marcheix, J. Porterie, E. Grunenwald, C. Cron, M. Galinier, O. LairezBackgroundNeurological complications of infective endocarditis (IE) concerns 20–40% of cases when symptomatic and 70% when asymptomatic. It is a well-identified gravity factor. Surgical indications in IE are larges and usual in emergency situations. However, neurological event, symptomatic or not, counts in surgical discussion. Sub-gr...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
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