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机械性血管内介入治疗由乳头状纤维弹性瘤完全脱落引起的急性缺血性卒中。

Mechanical endovascular procedure for the treatment of acute ischemic stroke caused by total detachment of a papillary fibroelastoma.

作者信息

Tejada Javier, Galiana Alberto, Balboa Oscar, Clavera Belén, Redondo-Robles Laura, Alonso Nieves, Magadán Víctor

机构信息

Department of Neurology, Hospital de León, León, Spain.

Department of Radiology, Hospital de León, León, Spain.

出版信息

J Neurointerv Surg. 2014 Jul;6(6):e37. doi: 10.1136/neurintsurg-2013-010800.rep. Epub 2013 Sep 7.

Abstract

Papillary fibroelastomas (PFEs) are rare cardiac tumors. Despite their benign nature, they are associated with a high risk of embolic complications including stroke. Endovascular treatment has been reported as a safe procedure in patients with myxoma, the most common type of primary cardiac tumor. A case of ischemic stroke due to embolization of a PFE successfully treated with a single pass of a retrievable stent is described. A 64-year-old patient with a right middle cerebral artery syndrome was treated with an intravenous and endovascular protocol as a revascularization procedure. Mechanical thrombectomy resulted in total recanalization with clinical improvement. Histological examination of the clot showed pathological features of a typical PFE. The endovascular treatment was safe and effective. With mechanical embolectomy it is possible to obtain and analyze pathological specimens, enabling the diagnosis of uncommon strokes.

摘要

乳头状纤维弹性瘤(PFEs)是罕见的心脏肿瘤。尽管其性质为良性,但它们与包括中风在内的栓塞并发症的高风险相关。血管内治疗已被报道为黏液瘤(最常见的原发性心脏肿瘤类型)患者的一种安全手术。本文描述了一例因乳头状纤维弹性瘤栓塞导致的缺血性中风,通过单次使用可回收支架成功治疗的病例。一名患有右大脑中动脉综合征的64岁患者接受了静脉和血管内治疗方案作为血管再通手术。机械取栓术导致血管完全再通,临床症状改善。对血栓的组织学检查显示了典型乳头状纤维弹性瘤的病理特征。血管内治疗安全有效。通过机械取栓术可以获取并分析病理标本,从而能够诊断罕见的中风。

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