Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
Cerebrovasc Dis. 2023;52(5):532-538. doi: 10.1159/000528218. Epub 2023 Jan 30.
The use of short-term mechanical circulatory support (MCS) devices and procedures for function- and life-sustaining therapy is becoming a routine practice at many centers. Concomitant with the increasing use of MCS is the increasing recognition of acute brain injuries, including acute ischemic stroke, which may be caused by a myriad of MCS-driven factors. The aim of this case series was to document our experience with mechanical thrombectomy (MT) for ischemic stroke in extracorporeal membrane oxygenation (ECMO) patients.
We retrospectively reviewed a prospectively maintained database of patients undergoing endovascular thrombectomy for large vessel occlusion at our institution. We identified patients that were on ECMO and underwent thrombectomy. Baseline demographics and procedural and functional outcomes were collected.
Three patients on ECMO were identified to have a large vessel occlusion and underwent thrombectomy. Two patients had an internal carotid artery terminus occlusion and one had a basilar artery occlusion. An mTICI 3 recanalization was achieved in all patients without postoperative hemorrhagic complications. Two patients achieved a 3-month mRS of 1, while one had mRS 4.
Ischemic stroke can be associated with significant morbidity in MCS patients. We demonstrate that MT can be safely performed in this patient population with good outcomes.
在许多中心，短期机械循环支持（MCS）装置和程序的使用已成为维持功能和生命的常规治疗方法。随着 MCS 使用的增加，越来越多的急性脑损伤被认识到，包括急性缺血性卒中，这可能是由多种 MCS 驱动因素引起的。本病例系列的目的是记录我们在体外膜氧合（ECMO）患者中进行机械血栓切除术（MT）治疗缺血性卒中的经验。
我们回顾性分析了在我们机构进行血管内血栓切除术治疗大血管闭塞的前瞻性维护数据库。我们确定了在 ECMO 上且进行了血栓切除术的患者。收集了基线人口统计学和程序及功能结果。
在 ECMO 上的 3 名患者被确定为有大血管闭塞并进行了血栓切除术。2 名患者为颈内动脉终末段闭塞，1 名患者为基底动脉闭塞。所有患者均实现了 mTICI 3 级再通，无术后出血性并发症。2 名患者在 3 个月时 mRS 为 1，1 名患者 mRS 为 4。
在 MCS 患者中，缺血性卒中可能与显著的发病率相关。我们证明 MT 可以在这种患者人群中安全进行，且具有良好的结果。
