2018 年 12 巻 4 号 p. 193-198
Objective: A case of cerebral embolism due to left atrial myxoma successfully treated using a direct aspiration first pass technique (ADAPT) is reported with a review of the literature.
Case Presentation: The patient was a 31-year-old male who developed left hemiparesis and dysarthria and was transported to our hospital. Based on MRI and MRA findings, a diagnosis of acute cerebral infarction due to occlusion of the distal part of M1 of the right middle cerebral artery, and transthoracic echocardiography suggested left atrial myxoma. Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) and mechanical thrombectomy were carried out, and complete recanalization could be achieved 196 minutes after the onset. The symptoms were resolved, and the embolus was pathologically confirmed to be left atrial myxoma.
Conclusion: ADAPT using Penumbra was suggested to be useful for the treatment of cardiogenic cerebral embolism due to left atrial myxoma.