Foetal radiation exposure caused by mechanical thrombectomy in large-vessel ischaemic stroke in pregnancy

Thrombolysis and Mechanical Thrombectomy for Acute Ischemic Stroke in Pregnancy: A Case Report

“…Several clinical methods in order to reduce fetal radiation exposure have been suggested as follows: the use of monoplane fluoroscopy where feasible, shielding of the gravid uterus using a lead apron, insertion of a sheath with minimal scanning, performance of the procedure via transradial or transbrachial access, reduction of the air gap between the flat panel detector and patient, and minimal use of magnification. 8,10) In the present case, we performed these methods except for via transradial or transbrachial access, we underwent transfemoral MT. These clinical methods led to a reduction of fetal radiation exposure.…”

“…4) Recently, case reports of MT for AIS in pregnancy have increased in number and suggested its efficacy and safety ( Table 1). 4,[6][7][8][9][10] In our case, although her NIHSS score was 2 and the site of occlusion was MCA M2 segment, the aphasia was moderate and could be an obstacle to parenting and work. The efficacy and continuous heparin infusion.…”

“…A report has suggested that hypothyroidism develops in newborns after the administration of iodinated contrast agents during pregnancy; however, another report has suggested that there is no difference in neonatal thyroid function. 2,10) A report suggested that iodinated contrast agents could be used in pregnant patients in the same dose as in non-pregnant patients when needed. 14) In our case, we use 170 ml of safety of MT for patients with M2 segment occlusion have not been established; however, Miura et al suggested the efficacy and safety of MT for patients with M2 segment occlusion compared with medical treatment.…”

Mechanical thrombectomy for acute stroke in pregnancy

“…49,50 A recent study of three cases of mechanical thrombectomy performed in pregnancy resulted in a mean estimated effective fetal dose of 0.024 (AE0.018) mGy. 51 A general consensus has emerged that when the fetal radiation dose is less than 50 mGy the non-carcinogenic risk, which includes abortion or fetal malformation, is negligible compared with the other risks encountered in pregnancy. 51 In conclusion, ischaemic stroke in pregnancy is associated with significant morbidity and mortality to the mother and fetus.…”

“…51 A general consensus has emerged that when the fetal radiation dose is less than 50 mGy the non-carcinogenic risk, which includes abortion or fetal malformation, is negligible compared with the other risks encountered in pregnancy. 51 In conclusion, ischaemic stroke in pregnancy is associated with significant morbidity and mortality to the mother and fetus. Mechanical thrombectomy has shown to be a treatment that has remarkable outcomes, which improve furthermore in the younger cohort, correlating with the age bracket of females in pregnancy.…”