Mechanical Thrombectomy for Acute Stroke in Patients with Target and Unrelated Vessel AVMs and AVFs: A Case Series

Caroline Hadley, Sunil Sheth, Kyle M. Fargen, Visish M. Srinivasan, Jacob Cherian, Stephen Chen, Jeremiah Johnson, Peter Kan

Research output: Contribution to journalArticle

Abstract

Background: Advances in acute and long-term poststroke care have resulted in improved survival and functional outcomes for patients who have suffered large vessel ischemic strokes. For years, tissue plasminogen activator was the mainstay of treatment for acute stroke. Its use was previously limited to patients without known comorbid intracranial vascular pathology because of concern for bleeding risk. More recently, however, the use of tissue plasminogen activator in select patients with vascular anomalies has increased and is now largely thought to be safe. With the safety and efficacy of mechanical thrombectomy now proven for large vessel occlusions (LVOs), similar investigation is needed to assess procedural safety in patients with concomitant arteriovenous (AV) malformations or fistulae. Methods: We reviewed patients treated for LVOs at our institution and those of our collaborators and identified 6 patients who were treated for LVO with either known or incidentally identified concomitant AV malformations or dural AV fistulae. Results: We present a case series of 6 patients with nonaneurysmal intracranial vascular lesions who underwent mechanical thrombectomy for LVO without complications related to these lesions. Conclusions: Although limited by small size, our series adds to the literature evidence that mechanical thrombectomy for LVO can safely be performed with concomitant dural AV fistulae and AV malformations.

Original languageEnglish (US)
Pages (from-to)e1255-e1261
JournalWorld Neurosurgery
Volume127
DOIs
StatePublished - Jul 2019
Externally publishedYes

Keywords

  • AVM
  • Dural AVF
  • Stroke
  • Thrombectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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