Endovascular Treatment of Infective Endocarditis-Related Acute Large Vessel Occlusion Stroke

Embolic stroke is a frequent complication of infective endocarditis yet lacks acute treatment as intravenous thrombolysis should be avoided due to high risk of intracerebral hemorrhage. Mechanical thrombectomy for large vessel occlusion may be a promising treatment but there is limited data on safety outcomes in infective endocarditis.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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ConclusionsStroke or stroke-like syndrome of infectious origin can be observed in an important proportion of case presenting with sensory-motor deficit of unknown origin; their accurate diagnosis has a considerable impact in terms of treatment choices and outcome.
Source: Infection - Category: Infectious Diseases Source Type: research
We read with much interest the article “Acute Ischemic Stroke Treatment in Infective Endocarditis: Systemic Review” by Bettencourt et al, published in your esteemed journal. Authors have reviewed 37 articles including 52 patients. Sixteen of whom received IV thrombolysis, 22 received mechanical thrombectomy, 11 received combined trea tment. The authors stated that the quality of the articles were low. And have concluded that the risk of intracerebral hemorrhage was 4 times higher in the group treated with IV thrombolysis comparing to the group treated with thrombectomy.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Letter to the editor 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
Publication date: June 2019Source: Archives of Cardiovascular Diseases Supplements, Volume 11, Issue 3Author(s): A. Farah, O. Ben Abdeljelil, W. Jomaa, A. Gana, K. Ben Hamda, F. MaatoukIntroductionDespite all improvements in diagnostic imaging modalities and therapeutic regimens, Infective endocarditis remains a lethal disease especially in children. Stroke is an uncommon complication of endocarditis in children but it is an important cause of acquired brain injury which is associated with a higher mortality rate.MethodThis was a prospective study that included all children diagnosed with infective endocarditis (IE) and ho...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology 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
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
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
Conclusion: Stroke is a common complication of IE. Mitral valve vegetation and old age may incerease the risk of stroke in patients with IE.Eur Neurol 2018;80:171 –178
Source: European Neurology - Category: Neurology Source Type: research
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