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Mechanical Thrombectomy of COVID-19 positive acute ischemic stroke patient: a case report and call for preparedness.
Mansour, Ossama Yassin; Malik, Amer M; Linfante, Italo.
  • Mansour OY; Neurology Department, Stroke and Neurointerventional Unit, Alexandria University, Faculty of Medicine, Alexandria, Egypt. yassinossama@yahoo.com.
  • Malik AM; Vascular Neurology Division, Department of Neurology, University of Miami Miller School of Medicine, Miami, USA.
  • Linfante I; Miami Cardiac and Vascular Institute, Baptist Neuroscience Institute, Florida International University, Miami, USA.
BMC Neurol ; 20(1): 358, 2020 Sep 24.
Article in English | MEDLINE | ID: covidwho-792799
ABSTRACT

BACKGROUND:

The novel coronavirus (COVID-19) global pandemic is associated with an increased incidence of acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO). The treatment of these patients poses unique and significant challenges to health care providers requiring changes in existing protocols. CASE PRESENTATION A 54-year-old COVID-19 positive patient developed sudden onset left hemiparesis secondary to an acute right middle cerebral artery occlusion (National Institutes of Health Stroke Scale (NIHSS) score = 11). Mechanical thrombectomy (MT) was performed under a new protocol specifically designed to maximize protective measures for the team involved in the care of the patient. Mechanical Thrombectomy was performed successfully under general anesthesia resulting in TICI 3 recanalization. With regards to time metrics, time from door to reperfusion was 60 mins. The 24-h NIHSS score decreased to 2. Patient was discharged after 19 days after improvement of her pulmonary status with modified Rankin Scale = 1.

CONCLUSION:

Patients infected by COVID-19 can develop LVO that is multifactorial in etiology. Mechanical thrombectomy in a COVID-19 confirmed patient presenting with AIS due to LVO is feasible with current mechanical thrombectomy devices. A change in stroke workflow and protocols is now necessary in order to deliver the appropriate life-saving therapy for COVID-19 positive patients while protecting medical providers.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Type of study: Case report / Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Middle aged Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S12883-020-01930-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Type of study: Case report / Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Middle aged Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S12883-020-01930-x