Neurological complications of infective endocarditis are frequent, especially ischaemic strokes. As intravenous thrombolysis in infective endocarditis-related ischaemic stroke has a controversial benefit/risk ratio, alternative treatment regimens have to be considered. We present the case of a young patient with septic embolism of the middle cerebral artery who was successfully treated with mechanical thrombectomy, and give a short review of the existing literature.
SonnevilleRMirabelMHajageDet al.Neurological complications and outcomes of infective endocarditis in critically ill patients: The ENDOcardite en REAnimation prospective multicenter study. Crit Care Med2011; 39: 1474–1481.
2.
AsaithambiGAdilMMQureshiAI. Thrombolysis for ischemic stroke associated with infective endocarditis: Results from the nationwide inpatient sample. Stroke2013; 44: 2917–2919.
3.
MasudaJYutaniCWakiRet al.Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis. Stroke1992; 23: 843–850.
4.
JunnaMLinCCEspinoaREet al.Successful intravenous thrombolysis in ischemic stroke caused by infective endocarditis. Neurocrit Care2007; 6: 117–120.
5.
BhuvaPShen-HanKHemphillJC. Intracranial hemorrhage following thrombolytic use for stroke caused by infective endocarditis. Neurocrit Care2010; 12: 79–82.
6.
DemaerschalkBMKleindorferDOAdeoyeOMet al.Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischemic stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke2016; 47: 581–641.
7.
GoyalMMenonBKvan ZwamWHet al.Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet2016; 387: 1723–1731.
8.
BainMDHussainMSGonuguntaVet al.Successful recanalization of a septic embolus with a balloon mounted stent after failed mechanical thrombectomy. J Neuroimaging2011; 21: 170–172.
9.
SukumaranSJayadevanERMandilyaAet al.Successful mechanical thrombectomy of acute middle cerebral artery occlusion due to vegetation from infective endocarditis. Neurol India2012; 60: 239–240.
10.
KanPWebbSSiddiquiAHet al.First reported use of retrievable stent technology for removal of a large septic embolus in the middle cerebral artery. World Neurosurg2012; 77: 591.e1–591.e5.
11.
DababnehHHednaVSFordJet al.Endovascular intervention for acute stroke due to infective endocarditis: Case report. Neurosurg Focus2012; 32: E1.
12.
KangGYangTKChoiJHet al.Effectiveness of mechanical embolectomy for septic embolus in cerebral artery complicated with infective endocarditis. J Korean Med Sci2013; 28: 1244–1247.
KimJMJeonJSKimYWet al.Forced arterial suction thrombectomy of septic embolic middle cerebral artery occlusion due to infective endocarditis: An illustrative case and review of the literature. Neurointervention2014; 9: 101–105.
15.
LadnerTRDavisBJHeLet al.Complex decision making in stroke: Preoperative mechanical thrombectomy of septic embolus for emergency cardiac valve surgery. BMJ Case Rep. 2014; bcr2014011488.
16.
ScharfELChakrabortyTRabinsteinAet al.Endovascular management of cerebral septic embolism: Three recent cases and review of the literature. J NeuroIntervent Surg2017; 9: 463–465.
17.
SveinsonOHerrmanLHolminS. Intra-arterial mechanical thrombectomy: An effective treatment for ischemic stroke caused by endocarditis. Case Rep Neurol2016; 8: 229–233.
