Endovascular Treatment for Acute Ischemic Stroke After Video-Assisted Thoracoscopic Pulmonary Lobectomy in Patients With Lung Cancer: A Report of Four Cases and Literature Review.

Abstract

BACKGROUND:

Postoperative cerebral embolic stroke is a serious complication of pulmonary lobectomy, occurring in 1.1% of patients undergoing lobectomy through video-assisted thoracoscopic surgery (VATS). The mechanism of this complication is thought to be embolic stroke caused by thrombus formed due to stagnation in the pulmonary vein stump after VATS lobectomy. There have been few reports demonstrating the utility of endovascular treatment (EVT) for cerebral embolic stroke after VATS lobectomy.

CASE DESCRIPTION:

In our case series, cerebral embolic stroke occurred after VATS pulmonary lobectomy for lung cancer, including the left upper lobe in three cases and the right lobe in one. The median duration of ischemic stroke after VATS was 4.5 days (interquartile range, 2-9 days). The median time from stroke onset to puncture was 130 min. Successful recanalization was achieved in all cases, and two patients achieved favorable clinical outcomes (modified Rankin scale, 0-2).

CONCLUSION:

We report a case series of four patients who underwent EVT for acute embolic stroke after VATS lobectomy for lung cancer. EVT is considered a reasonable and feasible therapeutic option for this condition.

• Authors: Hiroshi Ueno, Hiroto Yamaoka, Sakyo Hirai, Kyohei Fujita, Mariko Ishikawa, Shoko Fujii, Yuki Aizawa, Yosuke Ishii, Masataka Yoshimura, Kenji Yamada, Yoshikazu Yoshino, Morito Kurata, Katsutoshi Seto, Hironori Ishibashi, Kenichi Okubo, Shigeru Nemoto, Kazutaka Sumita
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) Vol. 31 Issue 8 Pg. 106593 (Aug 2022) ISSN: 1532-8511 [Electronic] United States
• PMID: 35696736 (Publication Type: Case Reports, Review)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Topics

• Embolic Stroke
• Humans
• Ischemic Stroke
• Lung Neoplasms (complications, diagnostic imaging, surgery)
• Pneumonectomy (adverse effects)
• Stroke (diagnostic imaging, etiology, therapy)
• Thoracic Surgery, Video-Assisted (adverse effects)