Mechanical thrombectomy can be an effective and prompt treatment for emergent bilateral large vessel occlusion strokes occurring as a periprocedural complication of TAVI.
May support bilateral thrombectomy for TAVI-related stroke; hypothesis-generating and requires prospective validation before practice change.
Mechanical thrombectomy has been described as the prompt procedure for emergent large vessel occlusion strokes resulting from cardioembolic events, arterial lesion-to-artery embolism, or from in situ atherosclerosis. This is the first reported case of an elderly woman who presented with bilateral paresis, progressive drowsiness, and dysarthria due to bilateral middle cerebral arterial occlusion, originating from the aortic valve, after transcatheter aortic valve implantation, leading to stroke. Despite intravenous thrombolysis being begun for this patient, it proved ineffective and she underwent mechanical thrombectomy, which led to complete revascularization of bilateral middle cerebral arteries following which she completely recovered without any deficits.
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Govindappa et al. (2022) studied this question.
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