Concomitant recent myocardial infarction (MI) in patients presenting with acute ischaemic stroke (AIS) is considered a relative contraindication for thrombolysis. Mechanical thrombectomy is recognised as an alternative recanalisation therapy to avoid risk of haemorrrhagic complications. We report a 77-year-old patient who previously had recent admission for late presentation ST elevation myocardial infarction (STEMI) and currently presented with right-sided hemiplegia, dysphasia and reduced level of consciousness at 30 minutes from the onset. An urgent cerebral angiography showed total occlusion of the left middle cerebral artery (MCA). Successful mechanical thrombectomy was performed instead of administration of intravenous (IV) thrombolysis with excellent neurological recovery. This case report highlights the importance of patient transfer to a more comprehensive stroke center in the management strategies of the AIS.
Mechanical Thrombectomy as an Alternative Reperfusion Therapy in Acute Ischaemic Stroke Associated with Recent Late Presentation of ST Elevation Myocardial Infarction
Author
Abstrak
Serangan strok iskemia akut di kalangan pesakit yang mempunyai sejarah serangan jantung infarksi miokardium yang baharu adalah kontraindikasi relatif kepada trombolisis. Intervensi melalui kaedah trombektomi mekanikal merupakan rawatan alternatif untuk mengelakkan komplikasi pendarahan. Laporan kes ini melaporkan pesakit berumur 77 tahun yang dimasukkan ke wad dengan hemiplagia sebelah kanan, disfagia dan kurang tahap kesedaran berdurasi 30 minit dan mempunyai sejarah rawatan untuk serangan jantung infarksi miokardium yang baharu. Angiografi serebral menunjukkan oklusi salur darah arteri serebral tengah sebelah kiri dan pesakit dirawat melalui intervensi trombektomi mekanikal. Pesakit menunjukkan peningkatan fungsi neurologi berikutan intervensi. Laporan kes ini menekankan kepentingan rawatan awal ke atas pesakit strok iskemia akut di pusat rawatan strok yang komprehensif.
Kata kunci
Abstract
Keywords
|
|
