Catheter thrombectomy for basilar artery stroke immediately after insertion of durable left ventricular assist device.
Vasiliki GregoryAmeesh IsathAtul D BaliFawaz Al-MuftiAvi LevineMasashi KaiSuguru OhiraPublished in: Perfusion (2023)
Background : Acute ischemic stroke (AIS) following left ventricular assist device (LVAD) implantation is a serious complication associated with device morbidity. AIS development following LVAD placement typically presents between 6- and 24-months post implantation. Case/Results : We report a case of a 67-year-old male who initially presented with reduced ejection fraction and severe coronary vessel disease. Following coronary artery bypass graft surgery, the patient remained in a low output state necessitating placement of an LVAD device. Approximately 4.5 hours following LVAD implantation, a severe acute decrease in mental status revealed new development of ischemic stroke of the basilar artery, which was successfully treated in one pass with catheter endovascular thrombectomy. Conclusion : While embolic stroke management in these cases remains difficult as patients are usually anticoagulated, our case demonstrates the utilization of endovascular thrombectomy as a viable therapeutic option in the setting of an uncommon occurrence of embolic stroke in the hours following LVAD implantation.
Keyphrases
- left ventricular assist device
- acute ischemic stroke
- coronary artery bypass
- atrial fibrillation
- ultrasound guided
- percutaneous coronary intervention
- end stage renal disease
- newly diagnosed
- ejection fraction
- minimally invasive
- coronary artery disease
- risk assessment
- coronary artery
- peritoneal dialysis
- prognostic factors
- early onset
- single cell
- brain injury
- patient reported outcomes
- acute coronary syndrome
- aortic valve
- left ventricular