title: Repeated Intra-Arterial Thrombectomy within 72 Hours in a Patient with a Clear Contraindication for Intravenous Thrombolysis.
abstract: Introduction. Treating patients with acute ischemic stroke, proximal arterial vessel occlusion, and absolute contraindication for administering intravenous recombinant tissue plasminogen activator (rtPA) poses a therapeutic challenge. Intra-arterial thrombectomy constitutes an alternative treatment option. Materials and Methods. We report a case of a 57-year-old patient with concomitant gastric adenocarcinoma, who received three intra-arterial thrombectomies in 72 hours due to repeated occlusion of the left medial cerebral artery (MCA). Findings. Intra-arterial recanalization of the left medial cerebral artery was performed three times with initially good success. However, two days later, the right medial cerebral artery became occluded. Owing to the overall poor prognosis at that time and knowing the wishes of the patient, we decided not to perform another intra-arterial recanalization procedure. Conclusion. To our knowledge, this is the first case illustrating the use of repeated intra-arterial recanalization in early reocclusion of intracranial vessels.
authors.affiliation: Department of Neurology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Mona
authors.initials: M
authors.lastname: Laible
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Möhlenbruch
authors.affiliation: Department of Neurology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Hacke
authors.affiliation: Department of Neuroradiology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bendszus
authors.affiliation: Department of Neurology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Peter Arthur
authors.initials: PA
authors.lastname: Ringleb
authors.affiliation: Department of Neurology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Timolaos
authors.initials: T
authors.lastname: Rizos