2003 Volume 31 Issue 5 Pages 338-343
Embolectomy has been sporadically carried out for acute middle cerebral artery (MCA) occlusion since the late 1950s. But since the introduction of local intra-arterial fibrinolysis, emergency embolectomy has not been widely carried out. Fibrinolysis, however, is not effective in all patients, and for those patients, we have applied acute embolectomy. Between October 1997 and March 2002, 9 patients with acute MCA occlusion were treated by embolectomy. The 9 patients had a mean time from onset to recanalization of 6 hours 32 minutes. Five of the 9 patients showed good recovery in Glasgow outcome scale, 2 were severely disabled, 1 was in a vegetative state, and 1 died of cardiac complication. None of the 9 patients had symptomatic hemorrhagic infarction requiring surgical removal.
In conclusion, emergency embolectomy can achieve good recovery even in patients with insufficient fibrinolysis after acute MCA occlusion.
