Acute stroke intervention for acute embolic procedural strokes performed by cardiologists.
Kerstin PiaydaIris GrunwaldKolja SievertStefan BertogHorst SievertPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2021)
Acute ischemic stroke is a feared complication during cardiovascular procedures associated with high morbidity and mortality if not immediately recognized and treated. We conducted a review of cases at our center where patients experienced an acute, procedure-related ischemic stroke and underwent immediate endovascular stroke treatment by the interventional cardiologists trained in acute endovascular stroke intervention. Baseline demographics, procedural and follow-up data were collected. Three patients were identified in whom the percutaneous procedure (peripheral arterial intervention, transapical NeoChord [NeoChord Inc, Minnesota, USA] implantation and transcatheter aortic valve implantation, respectively) was complicated by an acute embolic ischemic stroke. In all cases, cerebral vessel re-canalization was technically successful with thrombolysis in cerebral infarction (TICI) IIB/III flow. Follow-up computed tomography scans showed no infarct demarcation, oedema or intracranial hemorrhage. One patient survived with no neurological symptoms at 6-month follow-up whereas the two other patients died of unrelated intensive care complications and decompensated heart failure. We conclude that endovascular stroke treatment during cardiovascular interventions can be performed by interventional cardiologists with appropriate training. It offers the unique opportunity to treat cerebral embolization in a time-efficient manner, potentially improving morbidity and mortality of affected patients.
Keyphrases
- end stage renal disease
- heart failure
- computed tomography
- ejection fraction
- newly diagnosed
- randomized controlled trial
- chronic kidney disease
- atrial fibrillation
- transcatheter aortic valve implantation
- liver failure
- acute ischemic stroke
- prognostic factors
- magnetic resonance imaging
- mitral valve
- aortic valve
- magnetic resonance
- patient reported outcomes
- coronary artery disease
- machine learning
- aortic stenosis
- respiratory failure
- aortic valve replacement
- cerebral ischemia
- positron emission tomography
- pulmonary embolism
- minimally invasive
- optical coherence tomography
- high intensity
- pet ct
- artificial intelligence