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Case Report
Mechanical endovascular treatment of acute stroke due to cardiac myxoma
  1. Sara Garcia-Ptacek1,
  2. Jordi A Matias-Guiu1,
  3. Cristina Valencia-Sánchez1,
  4. Alberto Gil2,
  5. Israel Bernal-Becerra3,
  6. Virginia De las Heras-Revilla1,
  7. Carmen Serna-Candel2
  1. 1Department of Neurology, Hospital Clinico San Carlos, Madrid, Spain
  2. 2Department of Neuroradiology, Hospital Clinico San Carlos, Madrid, Spain
  3. 3Department of Anatomopathology, Hospital Clinico San Carlos, Madrid, Spain
  1. Correspondence to Dr Sara García-Ptacek, Department of Neurology, Hospital Clinico San Carlos c/prof Martin Lagos s/n 28040, Madrid, Spain; saragptacek{at}gmail.com

Abstract

Background Myxomas are rare cardiac tumors which often present with stroke caused by tumorous or thrombotic emboli. Treatment with intravenous recombinant tissue plasminogen activator (rtPA) and intra-arterial thrombolysis has been described previously but mechanical thrombectomy has not yet been reported, and treatment of myxoma-related ischemic stroke remains a clinical and technical challenge.

Methods Two patients with ischemic stroke due to cardiac myxoma in which mechanical thrombectomy was performed are presented.

Results Endovascular thrombectomy after intravenous rtPA (bridging therapy) was safely achieved in both cases, although with different clinical outcomes and degrees of recanalization.

Conclusions In stroke secondary to cardiac myxoma, mechanical thrombectomy might represent a safe and effective treatment option. The authors suggest the use of histological examination of the clot for diagnosis as its composition may explain the differences in treatment outcome.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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