Neurol. praxi. 2017;18(4):279-282 | DOI: 10.36290/neu.2017.098

Mechanical thrombectomy after the standard time window

MUDr. Ing. David Černík, MBA^{1, 3}, MUDr. Andrea Prcúchová^{1, 3}, MUDr. Filip Cihlář, Ph.D², doc. MUDr. Daniel Šaňák, Ph.D., FESO³

¹ KCC, Neurologie, Masarykova nemocnice Ústí nad Labem

² Radiodiagnostické odd., Masarykova nemocnice Ústí nad Labem

³ KCC, Neurologická klinika LF UP a FN Olomouc

Introduction: Mechanical thrombectomy is recommended standard treatment of occluded large cerebral artery within first 6hours since stroke onset. Beyond this standard therapeutic time window, thrombectomy may be beneficial in strictly selectedpatients only and upper treatment time limit has been still unknown. The aim was to document a positive clinical effect of thrombectomyperformed after 14 hours since stroke onset.

Methods: We describe a case of 73 y/o female, who presented with sudden severe left-sided hemiparesis at home. Shewas admitted to the stroke center after eleven hours after stroke onset with severe and fluctuating hemiparesis. AdmissionCT scan showed partial occlusion of right internal carotid artery (ICA) and occlusion middle cerebral artery (MCA) and relativelylarge ischemic penumbra on CT perfusion scans. Based on clinical symptoms, CT and MRI findings the mechanicalthrombectomy with successful recanalization of ICA and MCA was performed 14 hours after stroke onset with an excellentclinical outcome.

Conclusion: Mechanical thrombectomy is recommended a standard treatment of occluded large cerebral artery within first 6hours since stroke onset. Strictly selected patients with ischemic penumbral patterns may have benefit from mechanical thrombectomyeven beyond standard therapeutic time window.

Keywords: ischemic stroke, occlusion of internal carotid artery, occlusion of middle cerebral artery, mechanical thrombectomy

Published: October 1, 2017  Show citation