Mechanical thrombectomy for acute ischemic stroke with large vessel occlusion in pregnancy with mechanical heart valves： A case report

Renwei Zhang; Li Peng; Yao Xu; Yumin Liu

doi:10.1016/j.heliyon.2023.e18616

Mechanical thrombectomy for acute ischemic stroke with large vessel occlusion in pregnancy with mechanical heart valves： A case report

Heliyon. 2023 Jul 26;9(8):e18616. doi: 10.1016/j.heliyon.2023.e18616. eCollection 2023 Aug.

Authors

Renwei Zhang¹, Li Peng², Yao Xu¹, Yumin Liu¹

Affiliations

¹ Department of Neurology, Zhongnan Hospital of Wuhan Universtiy, Wuhan, China.
² Department of Cardiology, Zhongnan Hospital of Wuhan Universtiy, Wuhan, China.

Abstract

Background: The management of anticoagulation for mechanical heart valves (MHVs) during pregnancy posed a special challenge. Mechanical thrombectomy (MT) was the standard treatment for acute ischemic stroke (AIS) in anterior circulation with large vessel occlusion. However, the efficacy and safety of MT in the treatment of acute ischemic stroke in pregnancy were unknown.

Case presentation: A 29-year-old woman with MHVs in her first pregnancy at 7 weeks' gestation underwent MT because of a large occlusive thrombus in the end of the internal carotid artery despite therapeutic anticoagulation with low-molecular-weight heparin. This pregnant woman recovered well after MT with a modified rank score (mRS) of 0 at 90 days.

Conclusion: At present, there was no standard protocol of anticoagulation therapy for pregnant women with MHVs. Acute ischemic stroke with large vessel occlusion in pregnancy was rare, but could bring devastating consequences for both mother and infant. Our case report demonstrated that MT could be safe and effective in pregnancy.

Keywords: Acute ischemic stroke; Anticoagulation; Mechanical heart valves; Mechanical thrombectomy; Pregnant woman.

Publication types

Case Reports