Acute stroke intervention for acute embolic procedural strokes performed by cardiologists

Kerstin Piayda, Iris Grunwald, Kolja Sievert, Stefan Bertog, Horst Sievert (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Early online date22 Jun 2021
DOIs
Publication statusE-pub ahead of print - 22 Jun 2021

Keywords

  • acute stroke intervention
  • cardiovascular procedures
  • cerebral embolization
  • mechanical thrombectomy

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