Bilateral Simultaneous Middle Cerebral Artery Mechanical Thrombectomy for Periprocedural Transcatheter Aortic Valve Implantation Stroke: A Case Report

Abstract

Mechanical thrombectomy has been described as the prompt procedure for emergent large vessel occlusion strokes resulting from cardioembolic events, arterial lesion-to-artery embolism, or from in situ atherosclerosis. This is the first reported case of an elderly woman who presented with bilateral paresis, progressive drowsiness, and dysarthria due to bilateral middle cerebral arterial occlusion, originating from the aortic valve, after transcatheter aortic valve implantation, leading to stroke. Despite intravenous thrombolysis being begun for this patient, it proved ineffective and she underwent mechanical thrombectomy, which led to complete revascularization of bilateral middle cerebral arteries following which she completely recovered without any deficits.

Bilateral Middle Cerebral Artery Occlusion: A Successful Case of Bilateral Thrombectomy

“…More specifically, patients can present with diffuse cerebral edema, brain herniation, decerebrate posturing, and death [3][4][5][6]. The treatment for such a case is often mechanical thrombectomy, given that the patient presents within six to 24 hours [7][8][9][10]. After thrombectomy, clinicians will often report the Thrombolysis in Cerebral Infarction (TICI) score, which describes the flow in the vessels after an intervention.…”