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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
Semantic information from SemMedBD (by NLM)
1. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
2. Vascular occlusion CAUSES Acute Cerebrovascular Accidents
Subject
Vascular occlusion
Predicate
CAUSES
Object
Acute Cerebrovascular Accidents
3. Mechanical thrombectomy AFFECTS Patients
Subject
Mechanical thrombectomy
Predicate
AFFECTS
Object
Patients
4. Vascular occlusion PROCESS_OF Patients
Subject
Vascular occlusion
Predicate
PROCESS_OF
Object
Patients
5. Confirmed present PROCESS_OF Patients
Subject
Confirmed present
Predicate
PROCESS_OF
Object
Patients
6. Mechanical thrombectomy TREATS Confirmed present
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Confirmed present
7. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
8. Vascular occlusion CAUSES Acute Cerebrovascular Accidents
Subject
Vascular occlusion
Predicate
CAUSES
Object
Acute Cerebrovascular Accidents
9. Mechanical thrombectomy AFFECTS Patients
Subject
Mechanical thrombectomy
Predicate
AFFECTS
Object
Patients
10. Vascular occlusion PROCESS_OF Patients
Subject
Vascular occlusion
Predicate
PROCESS_OF
Object
Patients
11. Confirmed present PROCESS_OF Patients
Subject
Confirmed present
Predicate
PROCESS_OF
Object
Patients
12. Mechanical thrombectomy TREATS Confirmed present
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Confirmed present
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.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Type of study: Case report Language: English Journal: BMC Neurol Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Subject: Pneumonia, Viral / Thrombectomy / Coronavirus Infections / Infarction, Middle Cerebral Artery / Endovascular Procedures / Personal Protective Equipment Type of study: Case report Language: English Journal: BMC Neurol Year: 2020
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