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Brain & Heart Thrombectomy for stroke after cardiac surgery

occluded vessel. All patients were followed up for 90 days
from the time of receiving MT. Patients underwent 90‑day mRS 6 1 0 3 2 3 2 2 0
evaluation of neurological and/or functional status at onset
and at 24 h and 90 days after MT.
24‑h NIHSS 40 6 8 11 15 16 15 17 2
2.3. Data collection
Patient information was obtained from medical records. The Final score on eTICI 1 3 3 2a 2C 3 2C 2b67 3
data included demographic characteristics, comorbidities,
clinical data (cardiac surgery, atrial fibrillation [AF], and
NIHSS score at stroke onset and 24 h after MT), imaging Mismatch volume (mL) 90.4 215.8 63 188.9 61.5 7.1 292.2 64.3 211.6
data (occlusion site and penumbra volume), degree of
recanalization, time of onset to recanalization or final
angiography, stroke etiology, and outcome data (90-day Core infarct volume 41.3 1.9 188.5 1.8 100.6 91.1 0 3.5 7
mRS score). The mRS score is a tool for assessing the
degree of disability in patients with stroke, ranging from
0 to 6, with 0 indicating no symptoms and 6 indicating
death. Detailed information is presented in Table 1. Time from LKW to recanalization (min) 350 310 320 390 230 990 300 540 240
11
2.4. Statistical analysis
Continuous data are presented as mean ± standard
deviation for normally distributed data, and median
(interquartile range) for those with skewed distribution. occluded L-ICA terminal R-ICA terminal L-ACA+L-MCA L-ICA terminal
Data of categorical variables are presented as frequencies Vessel L-MCA R-MCA L-MCA L-ICA L-MCA
and percentages. Considering the small sample size,
descriptive statistics were used. Data were analyzed using NIHSS at stroke onset 16 16 14 12 16 16 18 18 18
IBM SPSS Version 23.0 software (IBM Corporation,
Armonk, NY, USA). 12 Abbreviations: ACA: Anterior cerebral artery; AF: Atrial fibrillation; CABG: Coronary artery bypass grafting; DM: Diabetes mellitus; EF: Ejection fraction; eTICI: Expanded thrombolysis in cerebral infarction; ICA: Internal carotid artery; L: Left; LKW: Last known well; MCA: Middle cerebral artery; mRS: Modified Rankin Scale; NIHSS: National Institutes of Health Strok
3. Results EF <50% after cardiac

Of these 21 patients, four were excluded because they had surgery No No Yes Yes No No No No Yes
only undergone digital subtraction angiography (DSA)
and eight were excluded because they did not undergo DM No No Yes No No No No No Yes
cardiac surgery. Finally, nine patients were included in
the analysis and all of them had completed pre-operative Post‑ operative
multimodal CT examination (Figure 1). The operations AF Yes No Yes Yes No No No No Yes
varied and comprised four coronary artery bypass grafts,
four surgical valve replacements, and one extended Preoperative
Morrow myectomy. The median time from post-surgery
to the onset of stroke symptoms was 4 days (interquartile AF No No No Yes No No No No No
range [IQR]: 2.5 – 5 days), the median National Institutes
of Health Stroke Scale score was 16 (IQR: 15 – 18), and Time from surgery to 5 4 4 10 3 0 5 2 5
the median time between the onset of symptoms and stroke (days)
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
(n = 1), a rehabilitation facility (n = 3), or home (n = 4). Surgery Valve surgery Valve surgery Valve surgery Valve surgery Extended morrow myectomy Note: All strokes are caused by cardioembolism.
The median 3‐month mRS was 2 (IQR: 0.5 – 3). Detailed Table 1. Summary of case series CABG CABG CABG CABG
information can be seen in Table 1. Age 66 65 50 50 58 53 69 42 69

3.1. Case 1 Sex F F M F F M M M M
A 66-year-old woman with dyspnea after exertion was Case
admitted to our hospital. Cardiac ultrasonography 1 2 3 4 5 6 7 8 9

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