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Acute Ischemic Stroke Management in a Patient with a Ventricular Assist Device

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by

Vishnu
in

Introduction

Managing acute ischemic stroke in patients with a ventricular assist device (VAD) presents unique challenges due to the complexities of anticoagulation and thromboembolic risks. A recent case study sheds light on how timely mechanical thrombectomy can significantly impact patient outcomes. Visit https://www.cardiologymedjournal.com/jccm for more groundbreaking research in this field.

Case Overview

A 50-year-old male patient with heart failure secondary to myocarditis had been on warfarin and aspirin since receiving a VAD. Despite maintaining an effective INR level, he experienced an acute ischemic stroke characterized by left-sided hemiparesis and confusion. Initial imaging confirmed an acute right M1 branch occlusion, necessitating immediate intervention.

Treatment and Outcome

  • Mechanical Thrombectomy: Due to contraindications for alteplase treatment (INR 2.92), the patient underwent mechanical thrombectomy within two hours of symptom onset.
  • Complete Reperfusion: A successful thrombolysis in cerebral infarction (TICI:3) score was achieved within 40 minutes.
  • Recovery: After nine days of monitoring, he was discharged with no neurological deficits (NIHSS: 0, mRS: 0).

Stroke Risks in VAD Patients

Patients with VADs are at an increased risk of thromboembolic complications. Studies indicate that 14% of VAD patients experience stroke, with nearly equal incidence rates of ischemic and hemorrhagic events. The American Heart Association (AHA) emphasizes the importance of optimal anticoagulation management and blood pressure control to mitigate these risks.

Key Takeaways

  • Prompt Intervention: Mechanical thrombectomy remains the preferred treatment in VAD patients with acute ischemic stroke.
  • Anticoagulation Balance: Maintaining INR levels between 3-3.5 can reduce thromboembolic risks without significantly increasing hemorrhage probability.
  • Multidisciplinary Care: Coordination between neurology, cardiology, and vascular specialists is crucial in stroke management.

Read the Full Study

For a detailed analysis, access the full study at https://doi.org/10.29328/journal.jccm.1001106.

Explore More

Discover more studies at https://www.cardiologymedjournal.com/jccm and join the conversation by sharing your thoughts in the comments below!

Disclaimer: This content is generated using AI assistance and should be reviewed for accuracy and compliance before considering this article and its contents as a reference. Any mishaps or grievances raised due to the reusing of this material will not be handled by the author of this article

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