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Mechanical thrombectomy
- 1. 1
- 2. Dr. Fawad Neurology Resident MECHANICAL THROMBECTOMY IN ACUTE ISCHEMIC STROKE CASE 3
- 3. 3 Patient Profile Name XYZ Age 23 Years Gender Female Resident - Date of Presentation 3 March 2020 MECHANICAL THROMBECTOMY Co morbids Mitral Stenosis with Atrial Fibrillation (on warfarin)
- 4. CASE 3 Presenting Complains Sudden onset right-sided weakness 5 1/2 hrs Aphasia She initially presented in AFIC ER and was then transferred to PEMH
- 5. CASE 3 Examination Findings GCS 15/15 Power Right Upper and Lower Limb 0/5 NIHSS 16, VAN Positive (Aphasia)
- 7. CASE 3 Imaging Findings CT Head - No bleed CTA Neck and Brain- Left MCA Occlusion
- 8. 8 Catheter angiography demonstrated occlusion of the Left MCA
- 9. 9 Left MCA trunk and Inferior Division was opened on second pass
- 10. 10 Left MCA superior division was opened on third aspiration
- 11. 11 Thrombus
- 12. 12 GCS Power Rt U/L Power Rt L/L Aphasia Immediate Post op 15/15 4/5 4/5 +ve CASE 3
- 13. 13 GCS Power Rt U/L Power Rt L/L Aphasia Post op Day 1 15/15 5/5 5/5 -ve CASE 3
- 14. ICA STENTING AND THROMBECTOMY IN ACUTE ISCHEMIC STROKE CASE 4
- 15. 15 Patient Profile Name XYZ Age 60 Years Gender Male Resident Rawalpindi Date of Presentation 27 Jan 2021 Co morbids None ICA STENTING AND THROMBECTOMY
- 16. CASE 4 Presenting Complains Sudden onset right-sided weakness 5 hrs Aphasia (Patient was out of tPA window)
- 17. CASE 4 Examination Findings GCS 10/15 NIHSS 20, VAN Positive Power Rt Upper and Lower Limb 0/5 Global Aphasia
- 18. CASE 4 Imaging Findings CT Head - No bleed CTA Neck and Brain- Critical ICA Stenosis (95%) CT Perfusion- Large region of hypo-perfusion of the left MCA territory
- 19. CT Head- Normal
- 20. CASE 4 Procedure Trial of Therapeutic Induced Hypertension was given but patient did not show any improvement He was shifted to the Cath Lab. Left ICA Angioplasty with Aspiration Thrombectomy and Stenting was done.
- 21. 21 Catheter angiography demonstrated critical occlusion of the Left ICA
- 22. 22
- 23. 23
- 24. 24
- 25. 25
- 26. CASE PRESENTATION Progress GCS Power Rt U/L Power Rt L/L Aphasia At Presentation 10/15 0/5 1/5 +ve 3rd day 14/15 1/5 3/5 -ve 5th day 15/15 4/5 4/5 -ve
- 27. 27
- 28. 28 Thank You
Editor's Notes
- In the name of Allah, the most beneficent and the most merciful
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs
- with headache for 5 hrs, slurry speech for 4.5 hrs and sudden weakness in left upper and lower limb for past 2 hrs