title: Endovascular management of cerebral septic embolism: three recent cases and review of the literature.
abstract: Endovascular management of acute ischemic stroke secondary to septic emboli from bacterial endocarditis is case-specific and outside established guidelines. We report three new cases of an acute ischemic stroke secondary to septic embolus from two different centers. All cases reported here were large vessel occlusions of the middle cerebral artery in anticoagulated patients. In one case the embolus was noted to be firm and aspiration thrombectomy was attempted in lieu of stent retrieval. Thrombolysis in Cerebral Ischemia (TICI) 3 recanalization was achieved and the patient experienced a good outcome with resolution of deficits. In this case, pathologic analysis of the embolus was available. These additional three cases from two centers add to the small but growing literature for interventional management of acute ischemic stroke in bacterial endocarditis.
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Eugene L
authors.identifier: http://orcid.org/0000-0003-2928-3924
authors.initials: EL
authors.lastname: Scharf
authors.affiliation: Department of Neurology, The Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Tia
authors.initials: T
authors.lastname: Chakraborty
authors.affiliation: Department of Neurology, The Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rabinstein
authors.affiliation: Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Amrendra S
authors.initials: AS
authors.lastname: Miranpuri
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods; D016896:Treatment Outcome
keywords: Embolic; Infection; Thrombectomy; guidewire