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Case Reports
. 2016 Apr-Jun;19(2):261-3.
doi: 10.4103/0972-2327.173302.

Mechanical thrombectomy for acute ischemic stroke in pregnancy using the penumbra system

Sanjith Aaron  1 , N K Shyamkumar  2 , Sunithi Alexander  2 , P Suresh Babu  1 , A T Prabhakar  1 , Vinu Moses  2 , T V Murthy  1 , Mathew Alexander  1
Affiliations
Case Reports

Mechanical thrombectomy for acute ischemic stroke in pregnancy using the penumbra system

Sanjith Aaron et al. Ann Indian Acad Neurol. 2016 Apr-Jun.

Abstract

Even though intravenous thrombolysis with tissue plasminogen activator (IV tPA) is the standard of care in acute ischemic stroke, its use in pregnancy is not clearly defined. Mechanical thrombectomy devices can be an option; however, literature on the use of such mechanical devices in stroke in pregnancy is lacking. Here we describe two cases that developed acute embolic stroke during pregnancy who were successfully treated by mechanical clot retrieval using the Penumbra system 28 (Penumbra Inc., Alameda, California, USA). To the best of our knowledge, these are the only case reports on the use of the Penumbra device in pregnant patients with acute ischemic stroke.

Keywords: Mechanical thrombectomy in pregnancy; penumbra system; stroke in pregnancy.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) DWI image showing a well defined infarct involving the right lateral lenticulostriate territory. (b) MRA and (c) DSA showing cut off of the right MCA, M1 segment (white arrows) (d) The Penumbra device deployed in the occluded segment.(e) Post procedure DSA showing partial recanalisation of the MCA with opacification of the inferior branch.(f) Imaging after 24 hours showing mild extension of the infarct to involve the right insula, (g) Evidence of good recanalisation on MRA of the right MCA
Figure 2
Figure 2
(a) DWI MRI images showing a well defined infarct involving the right putamen, (b) MRA and (C) DSA showing cut off of the right MCA in the proximal M1 segment, (c) The PENUMBRA Catheter (green arrow) deployed in the occluded segment (D) follow MRA showing partial recanalisation of the right MCA (d) T2 axial image after 1 month showing extension of infarct to involve only the territory of the superior branch of the right MCA
See this image and copyright information in PMC

References

    1. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med. 1995;333:1581–7. - PubMed
    1. Hacke W, Kaste M, Bluhmki E, Brozman M, Dávalos A, Guidetti D, et al. ECASS Investigators. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359:1317–29. - PubMed
    1. Aleu A, Mellado P, Lichy C, Köhrmann M, Schellinger PD. Hemorrhagic complications after off-label thrombolysis for ischemic stroke. Stroke. 2007;38:417–22. - PubMed
    1. Leonhardt G, Gaul C, Nietsch HH, Buerke M, Schleussner E. Thrombolytic therapy in pregnancy. J Thromb Thrombolysis. 2006;21:271–6. - PubMed
    1. Jauch EC, Saver JL, Adams HP, Jr, Bruno A, Connors JJ, Demaerschalk BM, et al. American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Peripheral Vascular Disease; Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44:870–947. - PubMed

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