Successful endovascular therapy in a hemodialysis patient with acute ischemic stroke

Abstract

A 67-year-old woman with a history of paroxysmal atrial fibrillation and combined valvular disease was suddenly admitted to our hospital due to acute left hemiplegia. She had been on maintenance hemodialysis for 18 years. Magnetic resonance imaging and magnetic resonance angiography revealed a newly formed embolism in her right middle cerebral artery. At this time, four hours and thirty minutes had passed since the onset of her acute ischemic stroke. We initially treated her with intravenous recombinant tissue plasminogen activator (rt-PA), but it did not improve her symptoms. So, endovascular therapy was administered, which resulted in successful endovascular recanalization and an improvement in the patient’s symptoms within 7 hours of the onset of her condition. The patient did not exhibit any neurological disorders, and therefore, was discharged on day 17 after admission. This report indicates that the administration of endovascular therapy soon after the failure of rt-PA might be effective against acute ischemic stroke in maintenance hemodialysis patients.