A Case of Mechanical Thrombectomy for Middle Cerebral Artery Occlusion with Trousseau Syndrome

Shinohara, Tadao; Tsumura, M; Hasegawa, Akio; Yamanaka, Yuji

doi:10.5797/jnet.cr.2016-0133

Cited by 12 publications

(15 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3) There are now multiple reports of mechanical thrombectomy for Trousseau's syndrome; however, recurrent thrombectomy for stroke is uncommon. [3][4][5][7][8][9][10] In two large series, recurrent thrombosis was reported at about 2%, although not all of these received repeat intervention. 6,11) These series differ on their impression of the impact of recurrent thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Triple Thrombectomy for Trousseau Syndrome: Case Report and Review of the Literature of Stroke Intervention in Cancer-associated Thrombus

Wassef

Grenga

Goldman

et al. 2020

JNET

View full text Add to dashboard Cite

There are few papers regarding repeat mechanical thrombectomy or thrombectomy for Trousseau's related stroke. We present a unique case of repeat thrombectomy due to Trousseau's syndrome affecting the same vessel in a patient with metastatic cancer. Case Presentation: A 47-year-old male presented with a full left middle cerebral artery syndrome and a National Institute of Health Stroke Scale of 17, despite regular apixaban use. He underwent mechanical thrombectomy successfully but developed recurrent symptoms on postoperative day (POD) 6 while on warfarin. He underwent two additional thrombectomies, the final one requiring glycoprotein IIa/IIIb inhibitor for emergent implantation of intracranial stent. Successful recanalization (thrombolysis in cerebral infarction 2b) was achieved, and the patient was discharged home on dual antiplatelet therapy and enoxaparin on POD 10 after last thrombectomy, ambulatory and independent in his activities of daily living. The patient expired as a result of his metastatic disease 109 days after the third procedure and was ambulatory for 91 of those days. Conclusion: This case illustrates the palliative aspects of mechanical thrombectomy and the complexities of anticoagulation management in patients with the metastatic disease Trousseau's syndrome.

show abstract

Section: Discussionmentioning

confidence: 99%

Triple Thrombectomy for Trousseau Syndrome: Case Report and Review of the Literature of Stroke Intervention in Cancer-associated Thrombus

Wassef

Grenga

Goldman

et al. 2020

JNET

View full text Add to dashboard Cite

show abstract

“…The present case is consistent with these characteristics. In cases where the prognosis is unfavorable because of terminal-stage cancer (3, 4), it is sometimes difficult to make a decision to undertake invasive surgery in patients in such poor condition. Recent article regarding endovascular therapy for cancer-related stroke revealed that the rate of good outcome at discharge was not significantly differ compared to those without cancer (5).…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy for Concurrent Cardio-Cerebral Infarction in a Patient With Trousseau Syndrome

et al. 2019

View full text Add to dashboard Cite

Only a few patients have been reported to undergo endovascular therapy for Trousseau syndrome. This is the first report of a patient with Trousseau syndrome who developed synchronous cardiocerebral infarction and underwent endovascular therapy for both. A 55-year-old woman with Trousseau syndrome arising from stage IV ovarian cancer presented with consciousness disturbance, aphasia, and right hemiparesis. Magnetic resonance imaging showed acute cerebral infarction limited to the left basal ganglia and occlusion of the left middle cerebral artery (MCA). Electrocardiography showed ST elevation in leads II, III, and aVF with reciprocal change. Mild elevation of myocardial enzymes was observed in laboratory data. She was diagnosed with synchronous cardiocerebral infarction. Both infarctions were considered as appropriately indicated for endovascular therapy. Since her vital signs were stable, a decision was made to treat the cerebral infarction first. Thrombectomy with a stent retriever was performed, which achieved complete recanalization of the left MCA. Percutaneous coronary intervention successfully recanalized the occluded right coronary artery. She suffered no recurrence of stroke or acute coronary syndrome upon heparin administration. Cardiocerebral infarction caused by Trousseau syndrome is rare and demands optimal planning of endovascular therapy.

show abstract

“…Four cases of thrombectomy for Trousseau syndrome have been reported. 6,9,10 More reports are available if tumor embolism is included, but none have described cases involving terminally ill patients. 22e24 Decision making in terminal care is very delicate and difficult.…”

Section: Commentmentioning

confidence: 99%

“…5 Trousseau syndrome is a common cause of ischemic stroke in cancer patients. 6 This syndrome was first reported by Armand Trousseau in 1865 and is characterized by hypercoagulation disorder in patients with malignancy. 7,8 This complication can markedly affect quality of life (QOL).…”

Section: Introductionmentioning

confidence: 98%

“…Mechanical thrombectomy is an effective clotremoving treatment for patients with acute cerebral infarction due to large vessel occlusion (LVO). However, thrombectomy for Trousseau syndrome has only rarely been described, 6,9,10 and no cases have yet been reported among terminally ill patients. This is the first report to describe the successful use of mechanical thrombectomy to rescue a terminally ill patient with LVO due to Trousseau syndrome.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mechanical Thrombectomy for Trousseau Syndrome in a Terminally Ill Cancer Patient

Hiramatsu¹,

Mori²,

Tanaka³

2019

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

Trousseau syndrome was first described by Armand Trousseau in 1865 and is characterized by hypercoagulation resulting from malignant tumors. This complication can markedly impact quality of life (QOL). This is the first report of a terminally ill patient who developed large-vessel occlusion stroke from Trousseau syndrome and underwent mechanical thrombectomy. A 75-year-old woman presented with Stage IV ovarian cancer. Goals of care were transitioned to palliative care. The patient was hospitalized with vertebral compression fracture and suddenly developed right hemiparesis and total aphasia during admission. Magnetic resonance imaging and angiography showed occlusion of Segment 1 of the left middle cerebral artery. We administered tissue-plasminogen activator, but symptoms remained unimproved. We performed mechanical thrombectomy based on medical indications and with the consent of her family. Thrombectomy improved symptoms dramatically. She was able to walk and talk with her family at discharge. She eventually died of respiratory failure on postoperative Day 98, but QOL remained high for those 98 days. Mechanical thrombectomy has the potential to markedly improve QOL in terminally ill patients with large-vessel occlusion associated with Trousseau syndrome.

show abstract

A Case of Mechanical Thrombectomy for Middle Cerebral Artery Occlusion with Trousseau Syndrome

Cited by 12 publications

References 17 publications

Triple Thrombectomy for Trousseau Syndrome: Case Report and Review of the Literature of Stroke Intervention in Cancer-associated Thrombus

Triple Thrombectomy for Trousseau Syndrome: Case Report and Review of the Literature of Stroke Intervention in Cancer-associated Thrombus

Endovascular Therapy for Concurrent Cardio-Cerebral Infarction in a Patient With Trousseau Syndrome

Mechanical Thrombectomy for Trousseau Syndrome in a Terminally Ill Cancer Patient

Contact Info

Product

Resources

About