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Brain & Heart

ORIGINAL RESEARCH ARTICLE
Multimodal computed tomography-guided

mechanical thrombectomy for large vessel
occlusion stroke after cardiac surgery

2
1†
1
Yao Feng 1† , Bincheng Wang , Na Zhao , Guitao Zhang , Bin Lu *,
2
and Shujuan Li *
1
1 Department of Neurology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking
Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
2 Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Abstract
Post-operative large vessel occlusion (LVO) stroke is one of the most severe
complications associated with cardiac surgery. Mechanical thrombectomy (MT) is
† These authors contributed equally the first-line treatment for LVO stroke. In this paper, we present cases of patients
to this work. who underwent MT guided by multimodal computed tomography (CT) to treat
*Corresponding authors: LVO stroke after cardiac surgery at our institution to clarify the impact of MT on
Shujuan Li patient outcomes. We analyzed the in-hospital stroke database from July 1, 2023,
(lishujuan@fuwai.com)
Bin Lu to June 30, 2024, to identify patients who had undergone MT to treat LVO stroke
(blu@vip.sina.com) after cardiac surgery in our institution. Demographic data, stroke severity, type of
Citation: Feng Y, Wang B, Zhao N, operation, imaging features, and 90-day modified Rankin scale (mRS) scores were
Zhang G, Lu B, Li S. Multimodal assessed. Of the 21 patients receiving endovascular therapy, we included nine
computed tomography-guided (42.9%) who had undergone multimodal CT-guided MT after cardiac surgery. The
mechanical thrombectomy for
large vessel occlusion stroke after operations varied and comprised four coronary artery bypass grafts, four surgical
cardiac surgery. Brain & Heart. valve replacements, and one extended Morrow myectomy. The median time from
2025;3(1):4141. post-surgery to the onset of stroke symptoms was 4 days (interquartile range
doi: 10.36922/bh.4141
[IQR]: 2.5 – 5 days), the median National Institutes of Health Stroke Scale score
Received: July 4, 2024 was 16 (IQR: 15 – 18), and the median time between the onset of symptoms and
1st revised: October 2, 2024 recanalization was 320 min (IQR: 270 – 465 min). One patient died of severe cerebral
hemorrhage, while eight patients survived and were discharged to another hospital
2nd revised: October 21, 2024
(n = 1), a rehabilitation facility (n = 3), or home (n = 4). The median 3‐month mRS was
Accepted: November 15, 2024 2 (IQR: 0.5 – 3). In summary, multimodal CT-guided MT can improve the prognosis of
Published online: December 2, patients with LVO stroke, although severe neurological deficits and mortality were
2024 observed in some patients. A larger sample size is required to clarify the effects of MT.
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: Cardiac surgery; Large vessel occlusion; Acute ischemic stroke; Mechanical
Creative Commons Attribution thrombectomy; Multimodal CT
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience 1. Introduction
Publishing remains neutral with Post-operative stroke is a serious complication of cardiac surgery, with an estimated
regard to jurisdictional claims in 1
published maps and institutional prevalence of 1 – 7.4%, and is associated with a hospital mortality rate of 3.0 – 38%,
affiliations. depending on the type of surgery. Ischemic stroke due to embolism is the most common
2

Volume 3 Issue 1 (2025) 1 doi: 10.36922/bh.4141