Mechanical Thrombectomy for Acute Ischemic Stroke Arising from Thrombus of the Left Superior Pulmonary Vein Stump after Left Pneumonectomy: A Case Report

Figures

• 

  Fig. 1. (A and B) Axial plain computed tomography showing an old infarction in the right occipital lobe and early ischemic change in the right middle frontal gyrus. (C) Axial contrast-enhanced computed tomography showing thrombus in the left superior pulmonary vein stump (arrow) and no evidence of an aortic dissection. (D and E) Pre- (D) and post- (E) treatment right internal carotid angiograms (frontal view). The superior trunk of the right middle cerebral artery is occluded (arrowhead), which was mechanically removed. The occluded middle cerebral artery was completely recanalized.

• 

  Fig. 2. Macroscopic photograph (A and B) and histological findings (C–F) of the retrieved embolus. The retrieved embolus appears as dark-red structure, and considers to be red thrombus (A, entire view with the stent-retriever; B, enlarged view). hematoxylin–eosin staining (original magnification: C, ×100; D, ×400) and Elastica-Masson staining (original magnification: E, ×100; F, ×400) shows that the retrieved embolus primarily consists of fibrin and erythrocytes. Scale bars: 100 μm.

• 

  Fig. 3. Post-operative findings of the imaging studies. Transesophageal echocardiography 6 days after thrombectomy (A) shows thrombus (arrow) in the left superior pulmonary vein stump. Transesophageal echocardiography 18 days after thrombectomy (B) and contrast axial computed tomography 19 days after thrombectomy (C) reveal complete disappearance of the thrombus.