篇名 | On-Table Catheter-Based Neurosalvage Performed by Cardiologists for Embolic Complication during an Endovascular Procedure |
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卷期 | 39:1 |
作者 | Li-Wei Liu 、 Hsien-Li Kao 、 Ying-Hsien Chen 、 Jiunn-Yang Chiang 、 Chih-Fan Yeh 、 Ching-Chang Huang 、 Chi-Chao Chao 、 Ya-Fang Chen 、 Yen-Bin Liu 、 Mao-Shin Lin |
頁次 | 162-168 |
關鍵字 | Acute stroke intervention 、 Cardiologist 、 Embolic complication 、 Neurosalvage 、 MEDLINE 、 Scopus 、 SCIE |
出刊日期 | 202301 |
DOI | 10.6515/ACS.202301_39(1).20220425C |
Objectives: To report our experience and clinical results of neurosalvage techniques, performed by interventional cardiologists without moving the patient, to manage cerebral thromboembolic complications. Background: Iatrogenic emboli may be released during an endovascular procedure, causing permanent neurological complications and catastrophic outcomes. Methods: Between July 2013 and December 2017, a total of eight patients suffered from embolic complications during endovascular procedures (two radiofrequency catheter ablation, five coronary angiogram/angioplasty, and one subclavian artery angioplasty). Catheter-based neurosalvage was attempted by experienced interventional cardiologists promptly in the same catheterization room. Results: The embolized locations were the M1 segment of the middle cerebral artery in four patients, the M2/M3 segments in three, and the basilar artery in one. Access to the supra-aortic vessels was achieved. Local intra-arterial thrombolysis was given in five patients (63%) and balloon angioplasty in three (38%). Intra-arterial thrombectomy with a stent retriever was attempted in three patients but failed in one. A combination of different techniques was used in three patients (38%). Final thrombolysis in cerebral infarction grade 3 flow was achieved in seven patients (88%). Favorable clinical outcomes at 1-month follow-up (modified Rankin scale of 0-2) were observed in seven patients (88%), and none of the patients had died at 12 months. Conclusion: Our experience demonstrated that acute embolic complications during an endovascular procedure can be salvaged by interventional cardiologists with acceptable angiographic and clinical results.