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J Neuroimaging. 2011 Apr;21(2):170-2. doi: 10.1111/j.1552-6569.2009.00457.x.

Successful recanalization of a septic embolus with a balloon mounted stent after failed mechanical thrombectomy.

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Cleveland Clinic Foundation, Cerebrovascular Center, Cleveland, Ohio 44195, USA.


Cardiac emboli are a feared complication for patients with left ventricular assist devices (LVAD). Septic emboli are rare but carry a poor prognosis in the setting of large artery occlusion. We report the case of a 24-year-old woman who presents with a left internal carotid artery terminus occlusion secondary to a septic emboli from a LVAD. The patient was not a candidate for intravenous thrombolytics due to an elevated international normalized ratio, and thus was taken for intra-arterial treatment. Initial treatment with mechanical thrombectomy and balloon angioplasty was not successful; thus, a balloon-mounted coronary stent was placed to achieve successful recanalization. Fragments of thrombus on the mechanical thrombectomy device revealed gram-positive bacilli on gram stain. Patients with large artery occlusion due to a septic embolus can be successfully treated with endovascular therapies in select patients.

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