Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis. Mechanical thrombectomy is most likely a more effective and safer treatment than intravenous thrombolysis in this patient group.
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http://dx.doi.org/10.1159/000452213 | DOI Listing |
JAMA Netw Open
January 2025
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.
Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.
Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.
Int J Stroke
January 2025
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Background: Acute ischemic stroke (AIS) from distal medium vessel occlusion (DMVO) presents unique treatment challenges. Mechanical thrombectomy (MT) is emerging as a viable option for these patients, yet the role of pre-stroke aspirin treatment is unclear. This study evaluates the impact of pre-stroke low-dose aspirin on outcomes in DMVO patients undergoing MT.
View Article and Find Full Text PDFPulmonary embolism (PE) is a life-threatening condition with varied presentations, occasionally mimicking ST-segment elevation myocardial infarction (STEMI). This case highlights a 52-year-old male patient with a history of venous thromboembolism (VTE) who presented with progressive shortness of breath over a month, culminating in dyspnea at rest, and anterior ST-segment elevation on electrocardiography (ECG). The initial evaluation suggested STEMI.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Good Samaritan Hospital, Cincinnati, USA.
Mechanical thrombectomy (MT) has revolutionized the management of proximal large vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS), improving long-term outcomes compared to standard treatments. However, despite its success in high-income countries, the widespread implementation of MT in Africa remains limited. With Africa experiencing one of the highest stroke burdens globally, this study examines the barriers impeding the adoption of MT in the region.
View Article and Find Full Text PDFJ Clin Med Res
January 2025
Department of Nephrology, Rutgers Health - Community Medical Center, Toms River, NJ 08755, USA.
Pulmonary embolism (PE) and acute ischemic stroke (AIS) are serious conditions with high morbidity and mortality. In the USA, PE causes around 100,000 deaths annually, with higher incidence in males. AIS following PE occurs in 1-10% of cases and is a leading cause of death within 2 - 4 weeks post-stroke.
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