A Case of Mechanical Thrombectomy for Middle Cerebral Artery Occlusion with Trousseau Syndrome

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Objective and Case Presentation: The patient was an 86-year-old woman with histories of surgery for stomach, colon, and pancreatic cancers. In addition to left hemiparesis as a sequela of two past episodes of cerebral infarction, she newly developed right hemiplegia and acute cerebral infarction due to left middle cerebral artery (MCA) occlusion. Since the condition was not an indication for intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA), mechanical thrombectomy was immediately performed, and almost complete recanalization could be achieved about 5 hours after the onset. The retrieved thrombus was a white and elastic hard fibrin thrombus that contained no blood cells. Although temporary symptomatic relief was obtained, bilateral MCA occlusion occurred in succession, and the patient died on the 35th day of illness.

Conclusion: Accumulation of cases and pathological evaluation of retrieved thrombi are necessary for the elucidation of the optimal mechanical thrombectomy or antithrombotic therapy for acute cerebral infarction due to Trousseau syndrome.