Repeated Mechanical Thrombectomy of Recurrent Large Vessel Occlusion: Case Report and Brief Review of the Literature

Abstract

Background Endovascular mechanical thrombectomy (MT) can significantly improve the prognosis of patients with Large Vessel Occlusion (LVO) stroke. It is still unclear whether it is safe and effective to perform MT again in patients with renal failure and atrial fibrillation (AF) in a short period of time. Case presentation We present the case of a LVO petients with concomitant AF and uremia who was successfully treated by MT for M1 segment occlusion of right middle cerebral artery (MCA) with good outcome. 15 days after the first MT, the patient's stroke recurred, angiography again revealed M1 segment and branch occlusion of right MCA, and repeated MT were performed. The recurrent strokes might attributed to no anticoagulant therapy. In an 4-months follow-up, no further vascular events occurred. Conclusions Repeated MT for recurrent LVO appears safe and effective. In patients with uremia and AF, it might be beneficial to give anticoagulant therapy after careful assessment of the patient's condition, which needs further evidence.