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Ischemic stroke
Case series
Endovascular management of cerebral septic embolism: three recent cases and review of the literature
  1. Eugene L Scharf1,
  2. Tia Chakraborty2,
  3. Alejandro Rabinstein2,
  4. Amrendra S Miranpuri3
  1. 1Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
  2. 2Department of Neurology, The Mayo Clinic, Rochester, Minnesota, USA
  3. 3Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Dr Eugene L Scharf, University of Rochester Medical Center, Department of Neurology, 601 Elmwood Avenue, Rochester, NY 14622, USA; Eugene_scharf{at}URMC.rochester.edu

Abstract

Endovascular management of acute ischemic stroke secondary to septic emboli from bacterial endocarditis is case-specific and outside established guidelines. We report three new cases of an acute ischemic stroke secondary to septic embolus from two different centers. All cases reported here were large vessel occlusions of the middle cerebral artery in anticoagulated patients. In one case the embolus was noted to be firm and aspiration thrombectomy was attempted in lieu of stent retrieval. Thrombolysis in Cerebral Ischemia (TICI) 3 recanalization was achieved and the patient experienced a good outcome with resolution of deficits. In this case, pathologic analysis of the embolus was available. These additional three cases from two centers add to the small but growing literature for interventional management of acute ischemic stroke in bacterial endocarditis.

  • Embolic
  • guidewire
  • Infection
  • Thrombectomy

https://doi.org/10.1136/neurintsurg-2016-012792

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    Footnotes

    • Contributors ELS: design/conceptualization of the study, data gathering, analysis or interpretation of the data, and drafting/revising the manuscript for intellectual content. TC, AR: analysis or interpretation of the data and drafting/revising the manuscript for intellectual content. ASM: design/conceptualization of the study, analysis or interpretation of the data, and drafting/revising the manuscript for intellectual content.

    • Competing interests None declared.

    • Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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