A Case Report of Re-occlusion after Mechanical Thrombectomy to the Patient with Protein C Deficiency-associated Cerebral Infarction

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Objective: We encountered the case of re-occlusion occurred within a short time after thrombectomy to the patient with acute cerebral embolism complicated by protein C deficiency. We have reported this case as its clinical presentation is rare and important for considering a treatment strategy for young adult-onset cerebral embolism in the future.

Case Presentation: A 34-year-old male developed dysarthria, aphasia, and right hemiparesis and was diagnosed with cerebral infarction caused by left M1 occlusion. Mechanical thrombectomy was performed and achieved recanalization, but the same region was re-occluded after 7 hours and thrombectomy was repeated. The patient was diagnosed with protein C deficiency based on the blood test findings. Re-occlusion was considered due to epithelial damage by a stent retriever and a hypercoagulable state induced by protein C deficiency.

Conclusion: Since young adult-onset cerebral embolism may be complicated by underlying disease, such as coagulopathy like this patient, the possibility of re-obstruction induced by epithelial damage should be considered.