Mechanical endovascular treatment of acute stroke due to cardiac myxoma.
BACKGROUND
Myxomas are rare cardiac tumors which often present with stroke caused by tumorous or thrombotic emboli. Treatment with intravenous recombinant tissue plasminogen activator (rtPA) and intra-arterial thrombolysis has been described previously but mechanical thrombectomy has not yet been reported, and treatment of myxoma-related ischemic stroke remains a clinical and technical challenge.


METHODS
Two patients with ischemic stroke due to cardiac myxoma in which mechanical thrombectomy was performed are presented.


RESULTS
Endovascular thrombectomy after intravenous rtPA (bridging therapy) was safely achieved in both cases, although with different clinical outcomes and degrees of recanalization.


CONCLUSIONS
In stroke secondary to cardiac myxoma, mechanical thrombectomy might represent a safe and effective treatment option. The authors suggest the use of histological examination of the clot for diagnosis as its composition may explain the differences in treatment outcome.
Department of Neurology, Hospital Clinico San Carlos, Madrid, Spain.
Sara
S
Garcia-Ptacek
Jordi A
JA
Matias-Guiu
Cristina
C
Valencia-Sánchez
Alberto
A
Gil
Israel
I
Bernal-Becerra
Virginia
V
De las Heras-Revilla
Carmen
C
Serna-Candel
D000328:Adult; D057510:Endovascular Procedures / Q000379:methods*; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009232:Myxoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome