title: Forced arterial suction thrombectomy of septic embolic middle cerebral artery occlusion due to infective endocarditis: an illustrative case and review of the literature.
abstract: In acute ischemic stroke patients with major intracranial vessel occlusion due to infective endocarditis, treatment modalities are not well established. A 40-year-old woman presented with acute stroke due to left middle cerebral artery occlusion. She was successfully treated with intra-arterial mechanical thrombectomy, and the subsequent clinical outcome was favorable. Pathological analysis of the retrieved clots showed septic thrombi containing gram-positive cocci. Based on literature review and the present case regarding treatment strategies for patients with septic embolic stroke, pharmacological thrombolysis might increase the risk of hemorrhagic complications, which might alter clinical outcome. Therefore, we can consider intra-arterial mechanical thrombectomy as a first-line treatment option in patients with acute stroke resulting from infective endocarditis.
authors.affiliation: Department of Neurology, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Neurology, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Ji-Su
authors.initials: JS
authors.lastname: Jeon
authors.affiliation: Department of Neurology, Kyungpook National University Hospital, Daegu, Korea. ; Department of Radiology, Kyungpook National University Hospital, Daegu, Korea. ; Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Yong-Won
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Radiology, Kyungpook National University Hospital, Daegu, Korea. ; Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea. ; Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Dong-Hun
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Neurology, Kyungpook National University Hospital, Daegu, Korea. ; Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Yang-Ha
authors.initials: YH
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Kyungpook National University Hospital, Daegu, Korea. ; Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea. ; School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Yong-Sun
authors.initials: YS
authors.lastname: Kim
keywords: Acute ischemic stroke; Infective endocarditis; Mechanical thrombectomy; Thrombolysis