Mechanical thrombectomy - an alternative treatment option in a patient with acute ischemic stroke and multiple contraindications for systemic thrombolysis: a case report.

Introduction: Acute ischemic stroke is a common cause of disability and death in developed countries. Standard therapy for patients who present within 4.5 hours from the onset of symptoms is intravenous thrombolysis if contraindications such as oral anticoagulation, cancer or recent surgery are ruled out. Apart from that, mechanical recanalization is a new treatment option for patients with occlusion of major cerebral arteries as a cause of ischemic stroke.

Case Presentation: In this case report we describe a 55-year-old Caucasian man with a right hemispheric ischemic syndrome who presented in time but who had multiple contraindications against systemic thrombolysis. He was then treated with mechanical recanalization and recovered. On discharge from the hospital he had only a slight left-sided facial paresis and discrete impairment of motion smoothness in his left hand.

Conclusion: We conclude that multimodal imaging should be performed in all patients with an acute onset of neurological symptoms suspicious of ischemic stroke, even if they have contraindications against an intravenous thrombolytic treatment.