Endovascular intervention for acute stroke due to infective endocarditis

Haitham Dababneh, V. Shushrutha Hedna, Jenna Ford, Ziad Taimeh, Keith Peters, J. Mocco, Michael F. Waters

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

The overall incidence of neurological complications due to infective endocarditis is as high as 40%, with embolic infarcts more common than hemorrhagic strokes. The standard of care for typical strokes does not apply to infective endocarditis because there is a substantial risk of hemorrhage with thrombolysis. In the last decade there have been multiple case reports of intravenous and intraarterial thrombolysis with successful outcomes for acute strokes with related infective endocarditis, but successful endovascular interventions for acute strokes associated with infective endocarditis are rarely reported. To the authors' knowledge, this report is the first case in the literature to use a mechanical retrieval device in successful vegetation retrieval in an infective endocarditis acute stroke. Although an interventional approach for treatment of acute stroke related to infective endocarditis is a promising option, it is controversial and a cautious clinical decision should be made on a case-by-case basis. The authors conclude that this approach can be tested in a case series with matched controls, because this condition is rare and a randomized clinical trial is not a realistic option.

Original languageEnglish (US)
Article numberE1
JournalNeurosurgical focus
Volume32
Issue number2
DOIs
StatePublished - Feb 1 2012

Keywords

  • Infective endocarditis
  • Interventional endovascular procedure
  • Ischemic penumbra
  • Middle cerebral artery
  • Penumbra retrieval device

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