A case of major cerebral artery occlusion with acute myocardial infarction undergoing acute endovascular revascularization after percutaneous coronary intervention

DOI Web Site 6 References

Bibliographic Information

Other Title
  • 急性心筋梗塞合併の脳主幹動脈閉塞症に対し，経皮的冠動脈形成術先行で血栓回収療法を行った1例

Search this article

Abstract

<p>An 89-year-old man suddenly developed left hemiplegia and was transported to our hospital about 40 minutes later. On admission, the level of consciousness was 2 on the JCS, and right conjugate deviation and severe left hemiplegia were observed. The NIHSS score was 21. A hyperdense MCA sign in the right M1 was observed on CT but no early cerebral ischemic changes. Electrocardiography revealed ST-segment elevation, and cardiogenic cerebral embolism associated with acute myocardial infarction was diagnosed. rt-PA intravenous therapy was skipped, and percutaneous coronary angioplasty for acute myocardial infarction was performed. Cerebral angiography was then performed, confirming occlusion of the right MCA M1 proximal region. Acute endovascular revascularization was performed, obtaining complete recanalization. The time from puncture to recanalization was 73 minutes. After treatment, the patient was able to lift the left upper and lower extremities and was transferred to another hospital with mRS 3. When both diseases are present, the order of treatment should be considered on a case-by-case basis. This case was judged to have highly severe acute myocardial infarction, which was therefore prioritized. Diagnosis by CT alone and skipping rt-PA intravenous therapy allowed treatment time to be minimized.</p>

Journal

References(6)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top