Key result
Mechanical thrombectomy achieves complete recanalization in rt-PA-resistant MCA occlusion from cardiac myxoma.
Why the study?
Cardiac tumor is a rare cause of cerebral embolic infarction with no established therapeutic strategies, especially for tumorous emboli unresponsive to rt-PA.
Does mechanical endovascular thrombectomy improve outcomes in patients with MCA occlusion from cardiac myxoma emboli?
Case Report (n=1)
No
Does mechanical endovascular thrombectomy improve outcomes in patients with MCA occlusion from cardiac myxoma emboli?
Emergency mechanical thrombectomy is a viable and effective treatment option for acute ischemic stroke caused by elastic hard cardiac myxoma emboli that do not respond to rt-PA.
Mechanical thrombectomy may succeed where rt-PA fails in tumor emboli; leaves open optimal strategies pending prospective data.
Cardiac tumor is a rare cause of cerebral embolic infarction which has no established therapeutic strategies. Although some cases were successfully treated by recombinant tissue-plasminogen activator (rt-PA), this article indicates the effectiveness of emergency mechanical thrombectomy for tumorous type of emboli which do not respond to rt-PA. A 34-year-old man presented with ischemic stroke and right middle cerebral artery (MCA) occlusion by cardiac tumor originating emboli. Intravenous rt-PA therapy was ineffective, but mechanical endovascular thrombectomy using Merci Retriever was successful. His neurological deficit began to improve and good outcome was obtained at discharge. The embolus was histologically identical to a cardiac myxoma, confirmed and treated successfully by surgery later. We report the first successfully treated tumorous embolic stroke case with cardiac tumor by using Merci Retriever. Emergency mechanical thrombectomy would be an option for elastic hard myxoma emboli.
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Ryu et al. (2015) conducted a case report in Middle Cerebral Artery Occlusion by Tumorous Emboli Originating from Cardiac Myxoma (n=1). Mechanical endovascular thrombectomy using Merci Retriever was evaluated on Recanalization (TICI grade) and neurological improvement. Mechanical endovascular thrombectomy using the Merci Retriever successfully achieved complete recanalization and neurological improvement in a patient with middle cerebral artery occlusion caused by an rt-PA-resistant cardiac myxoma embolus.