Effective ADAPT Thrombectomy in a Patient with Acute Stroke due to Cardiac Papillary Elastofibroma: Histological Thrombus Confirmation

Biraschi Francesco; Diana Francesco; Alesini Francesco; Guidetti Giulio; Peschillo Simone

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Effective ADAPT Thrombectomy in a Patient with Acute Stroke due to Cardiac Papillary Elastofibroma: Histological Thrombus Confirmation

机译：由于心脏乳头状弹性纤维纤维纤维纤维纤维纤维纤维纤维纤维纤维纤维瘤，有效适应患者急性中风的血液切除术：组织学血栓确认

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A 75-year-old man with hypertension and atrial fibrillation was admitted to our emergency room with right-sided hemiplegia and complete aphasia (National Institutes of Health Stroke Scale [NIHSS] score = 18). A noncontrast computed tomography scan showed a slight hypodensity in the left insular region and a bright hyperdense sign in the M1 tract of the left middle cerebral artery (MCA). Angio-CT confirmed an occlusion of the M1 tract of the MCA. Magnetic resonance diffusion-weighted imaging/perfusion-weighted imaging was obtained and revealed a mismatch in the left parietal cortical region. Complete revascularization was achieved by thromboaspiration with the A Direct ASPIRATION first PASS TECHNIQUE (ADAPT) technique. Histological examination of the embolic material revealed its nonthrombotic nature: cardiac embolic papillary elastofibroma (PEF). At discharge, good recovery of right-side hemiplegia was observed. This case report is the second in literature in which a histological confirmed cardiac embolic PEF is reported as a cause of embolic stroke. PEF is a rare but potentially treatable cause of embolic stroke. Understanding the nature of the embolic material would help in choosing the best revascularization approach.

机译：一名患有高血压和心房颤动的75岁男子因右侧偏瘫和完全失语（美国国立卫生研究院卒中量表[NIHSS]评分=18）入院。非对比CT扫描显示左大脑中动脉（MCA）左侧岛叶区轻度低密度，M1束有明亮的高密度征象。血管造影CT证实大脑中动脉M1束闭塞。获得磁共振扩散加权成像/灌注加权成像，发现左顶叶皮质区域不匹配。完全血运重建是通过血栓抽吸和直接抽吸首过技术（ADAPT）实现的。栓塞材料的组织学检查显示其非血栓性质：心脏栓塞性乳头状弹性纤维瘤（PEF）。出院时，观察到右侧偏瘫恢复良好。本病例报告是文献中第二例经组织学证实的心脏栓塞性PEF被报告为栓塞性卒中的原因。PEF是一种罕见但可能可治疗的栓塞性中风病因。了解栓塞材料的性质将有助于选择最佳的血管重建方法。

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来源
《Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association》 |2016年第10期|共3页
作者
Biraschi Francesco; Diana Francesco; Alesini Francesco; Guidetti Giulio; Peschillo Simone;
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作者单位

Univ Roma La Sapienza Dept Neurol &

Psychiat Endovasc Neurosurg Intervent Neuroradiol Rome Italy;

Univ Roma La Sapienza Dept Radiol Rome Italy;

Univ Roma La Sapienza Dept Oncol Radiol &

Anatomopathol Sci Rome Italy;

Univ Roma La Sapienza Dept Neurol &

Psychiat Endovasc Neurosurg Intervent Neuroradiol Rome Italy;

Univ Roma La Sapienza Dept Neurol &

Psychiat Endovasc Neurosurg Intervent Neuroradiol Rome Italy;

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正文语种 eng
中图分类神经病学与精神病学;
关键词
Stroke; mechanical thrombectomy; papillary elastofibroma; cardiac embolism; MR perfusion; ADAPT; thrombus;

机译：(打、击等的)一下机械血栓切除术;乳头状弹性纤维瘤;心脏栓塞;磁共振灌注;适应血栓;

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3. Effective ADAPT Thrombectomy in a Patient with Acute Stroke due to Cardiac Papillary Elastofibroma: Histological Thrombus Confirmation [J] . Biraschi Francesco, Diana Francesco, Alesini Francesco, Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association . 2016,第10期

机译：由于心脏乳头状弹性纤维纤维纤维纤维纤维纤维纤维纤维纤维纤维纤维瘤，有效适应患者急性中风的血液切除术：组织学血栓确认
4. A comparison of acute vascular damage caused by ADAPT versus a stent retriever device after thrombectomy in acute ischemic stroke: a histological and ultrastructural study in an animal model [J] . Peschillo S., Diana F., Berge J., Journal of neurointerventional surgery . 2017,第8期

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5. A prospective randomized trial of thrombectomy versus no thrombectomy in patients with ST-segment elevation myocardial infarction and thrombus-rich lesions: MUSTELA (MUltidevice Thrombectomy in Acute ST-Segment ELevation Acute Myocardial Infarction) trial [J] . JACC. Cardiovascular interventions . 2012,第12期

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6. Cardiopulmonary Bypass(CPB) Strategy Using Nafamostat Mesilate In Cardiac Surgery: A Safety Option For Patients With Acute Stroke [C] . Morimoto N., Mukohara N., Tauchi Y., European Society for Surgical Research . 2010

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7. A Novel, Non-Biological Clot Material for Simulating Mechanical Thrombectomy in Acute Ischemic Stroke. [D] . Santore, Joseph. 2013

机译：一种新型的非生物凝块材料，用于模拟急性缺血性卒中的机械血栓切除术。
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机译：急性缺血性卒中血栓切除术后由ADAPT和支架检索装置引起的亚急性血管损伤的比较：动物模型的组织学和超微结构研究
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机译：探讨问题：新出现的管理护理211环境中211急性心肌梗死/急性心肌缺血患者的快速鉴别和治疗。执行摘要和会议记录。在马里兰州211的贝塞斯达举行

Effective ADAPT Thrombectomy in a Patient with Acute Stroke due to Cardiac Papillary Elastofibroma: Histological Thrombus Confirmation

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