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Abstract:

In clinical practice, ischemic stroke still remains a difficult problem, being in most leading causes of death. Development of new treatments, founding of new therapeutic algorythmes and untiringly technical progress in sphere of instrumental support of operation-room allow to proceed endovascular intervention in group of patients with cardioembolic stroke.

Case report presents successful endovascular treatment of patient from cardio-surgical department of Belgorod Region Clinical Hospital named after St. loasaf, with cardioembolic stroke, onset in preoperative period (before aorto-coronary bypass).

Materials and methods: patient A., 59 years, diagnosis: «Ischemic heart disease. Exertional angina FC II. Post-infarction cardiosclerosis. (AMI in September 2014). Stenosis of coronary arteries according to coronary angiography (CAG), hemodynamically significant. Hypertensive heart disease III st., 2 degree, with the defeat of the heart and blood vessels of the brain, with the achievement of target blood pressure (BP). Diabetes mellitus type 2, the second insulin-depended, stage subcompensation. Risk factor 4. congestive heart failure 2a class, functional class III. Chronic gallstone disease. Chronic calculous cholecystitis without exacerbation». 05.02.15 - onset of ischemic stroke in left hemisphere of brain. Patient urgently underwent: multislice computed tomography (MSCT), MSCT-angiography of main brain arteries, direct angiography of main brain arteries. Survey showed: occlusion of proximal third of left common carotid artery (CCA) with TICI-0 blood flow; left middle cerebral artery (MCA) and anterior cerebral artery (ACA) were filled threw anterior communicating artery (ACoA) from right internal carotid artery (ICA). Patient underwent: recanalization of occlusion, thrombectomy from left CCA, stenting of CCA-ICA segment, selective thrombolythic therapy into left MCA.

Results: «Time-To-Treatment» was 4 hours 15 minutes. Made endovascular treatment leaded to regression of neurological deficit.

Conclusions: the use of endovascular methods in patients with cardioembolic stroke car decrease neurological deficit and increase quality of life of patients in this group.  

 

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