Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Case Reports
Triple Thrombectomy for Trousseau Syndrome: Case Report and Review of the Literature of Stroke Intervention in Cancer-associated Thrombus
Catherine WassefAudrey GrengaBruce GoldmanThomas Mattingly
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JOURNALS OPEN ACCESS

2020 Volume 14 Issue 8 Pages 301-306

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Abstract

Objective: There are few papers regarding repeat mechanical thrombectomy or thrombectomy for Trousseau’s related stroke. We present a unique case of repeat thrombectomy due to Trousseau’s syndrome affecting the same vessel in a patient with metastatic cancer.

Case Presentation: A 47-year-old male presented with a full left middle cerebral artery syndrome and a National Institute of Health Stroke Scale of 17, despite regular apixaban use. He underwent mechanical thrombectomy successfully but developed recurrent symptoms on postoperative day (POD) 6 while on warfarin. He underwent two additional thrombectomies, the final one requiring glycoprotein IIa/IIIb inhibitor for emergent implantation of intracranial stent. Successful recanalization (thrombolysis in cerebral infarction 2b) was achieved, and the patient was discharged home on dual antiplatelet therapy and enoxaparin on POD 10 after last thrombectomy, ambulatory and independent in his activities of daily living. The patient expired as a result of his metastatic disease 109 days after the third procedure and was ambulatory for 91 of those days.

Conclusion: This case illustrates the palliative aspects of mechanical thrombectomy and the complexities of anticoagulation management in patients with the metastatic disease Trousseau’s syndrome.

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© 2020 The Japanese Society for Neuroendovascular Therapy

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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