Intra-Arterial Mechanical Thrombectomy: An Effective Treatment for Ischemic Stroke Caused by Endocarditis

TLDR

Infective endocarditis-associated strokes carry high morbidity and mortality, with only about one‑third of patients becoming functionally independent, and thrombolytic therapy is generally considered a relative contraindication. Three consecutive cases of middle cerebral artery occlusion due to infective endocarditis were successfully treated with intra‑arterial mechanical thrombectomy using the Solitaire device. Mechanical thrombectomy appears to be an effective and potentially safer acute treatment for ischemic stroke in patients with infective endocarditis compared with intravenous thrombolysis.

Abstract

Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis. Mechanical thrombectomy is most likely a more effective and safer treatment than intravenous thrombolysis in this patient group.