Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery.

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dc.contributor.authorGupta, A.K.
dc.contributor.authorSabab, A.
dc.contributor.authorGoh, R.
dc.contributor.authorOvenden, C.D.
dc.contributor.authorKovoor, J.G.
dc.contributor.authorRamponi, F.
dc.contributor.authorChan, J.C.Y.
dc.contributor.authorReddi, B.A.J.
dc.contributor.authorBennetts, J.S.
dc.contributor.authorMaddern, G.J.
dc.contributor.authorKleinig, T.J.
dc.date.issued2022
dc.description.abstractIntroduction: Acute ischemic stroke (AIS) can be a catastrophic complication of cardiac surgery previously without effective treatment. Endovascular thrombectomy (EVT) is a potentially life‐saving intervention. We examined patients at our institution who had EVT to treat AIS post cardiac surgery. Methods: We retrospectively reviewed a stroke database from January 1, 2016 to October 31, 2021 to identify patients who had undergone EVT to treat AIS following cardiac surgery. Demographic data, operation type, stroke severity, imaging features, management and outcomes (mortality and modified Rankin Score (mRS)) were assessed. Results: Of 5022 consecutive patients with AIS, 870 underwent EVT. Seven patients (0.8%) had EVT following cardiac surgery. Operations varied: two coronary artery bypass grafting (CABG), two transcatheter AVR, one redo surgical aortic valve replacement (AVR), one mitral valve repair and one patient with combined aortic and mitral valve replacements and CABG. Meantime postsurgery to stroke symptoms onset was 3 days (range 0–9 days). Median NIHSS was 26 (range 10–32). Five patients had middle cerebral artery occlusion and two internal carotid artery (n = 2). Median time between onset of symptoms and recanalization was 157 min (range 97–263). Two patients received Intra‐arterial Thrombolysis. All patients survived and were discharged to another hospital (n = 3), home (n = 2), or rehabilitation facility (n = 2). Median 3‐month mRS was 3 (range 0–6). Conclusion:We report the largest case series of EVT after cardiac surgery. EVT can be associated with excellent outcomes in these patients. Close neurological monitoring postoperatively to identify patients who may benefit from intervention is key.
dc.description.statementofresponsibilityAashray K. Gupta, Ahad Sabab, Rudy Goh, Christopher D. Ovenden, Joshua G. Kovoor, Fabio Ramponi, Justin C. Y. Chan, Benjamin A. J. Reddi, Jayme S. Bennetts, Guy J. Maddern, Timothy J. Kleinig
dc.identifier.citationJournal of Cardiac Surgery, 2022; 37(12):4562-4570
dc.identifier.doi10.1111/jocs.17082
dc.identifier.issn0886-0440
dc.identifier.issn1540-8191
dc.identifier.orcidGupta, A.K. [0000-0002-8038-0378]
dc.identifier.orcidGoh, R. [0000-0003-1645-2258]
dc.identifier.orcidOvenden, C.D. [0000-0001-8075-7852]
dc.identifier.orcidKovoor, J.G. [0000-0002-3880-3840]
dc.identifier.orcidChan, J.C.Y. [0000-0002-6766-4122]
dc.identifier.orcidMaddern, G.J. [0000-0003-2064-181X]
dc.identifier.orcidKleinig, T.J. [0000-0003-4430-3276]
dc.identifier.urihttps://hdl.handle.net/2440/145810
dc.language.isoen
dc.publisherWiley
dc.rights© 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
dc.source.urihttps://doi.org/10.1111/jocs.17082
dc.subjectcardiovascular pathology; cardiovascular research; coronary artery disease; valve repair/ replacement
dc.subject.meshHumans
dc.subject.meshBrain Ischemia
dc.subject.meshTreatment Outcome
dc.subject.meshCoronary Artery Bypass
dc.subject.meshThrombectomy
dc.subject.meshRetrospective Studies
dc.subject.meshStroke
dc.subject.meshEndovascular Procedures
dc.subject.meshIschemic Stroke
dc.titleEndovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery.
dc.typeJournal article
pubs.publication-statusPublished online

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