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Management of acute ischemic stroke after pulmonary resection: incidence and efficacy of endovascular thrombus aspiration

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Abstract

Objective

We analyzed acute ischemic stroke by thromboembolism in the early period after lung cancer surgery.

Methods

A retrospective review of the clinical records of patients who underwent lung resection for primary lung cancer was performed. Patients who underwent lobectomy, bilobectomy, and pneumonectomy were included. The clinical characteristics of the patients, the incidence of atrial fibrillation (Af) after surgery, and the incidence of acute ischemic stroke were analyzed. The clinical courses of patients having acute ischemic stroke were also reviewed.

Results

In 4 (0.6%) of 696 patients, acute ischemic stroke occurred in the early period during hospitalization after lung cancer surgery. Acute ischemic stroke occurred within 4 days in three cases and after 4 days in one case. The resection site of the lung was the left side in all cases, and there were three cases of left upper lobectomy and one case of left lower lobectomy. As for the two recent patients, thrombus removal was performed by a neurosurgeon, and both cases achieved successful recanalization. The time between symptom detection and recanalization was 205 and 170 min, respectively. One patient was cured without any residual effect of disease, and the other patient’s hemiplegia resolved and aphasia improved.

Conclusion

Since cerebral infarction impairs the patient’s quality of life, thrombus removal should be considered if possible.

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Daisuke Kimura, Ikuo Fukuda, Takao Tsushima, Takehiro Sakai & Satoko Umetsu

  2. Department of Neurosurgery, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Yukari Ogasawara, Norihito Shimamura & Hiroki Ohkuma

Authors
  1. Daisuke Kimura
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  2. Ikuo Fukuda
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  3. Takao Tsushima
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  4. Takehiro Sakai
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  5. Satoko Umetsu
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  6. Yukari Ogasawara
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  7. Norihito Shimamura
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  8. Hiroki Ohkuma
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Corresponding author

Correspondence to Ikuo Fukuda.

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The author has declared that no conflict of interest exists.

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Kimura, D., Fukuda, I., Tsushima, T. et al. Management of acute ischemic stroke after pulmonary resection: incidence and efficacy of endovascular thrombus aspiration. Gen Thorac Cardiovasc Surg 67, 306–311 (2019). https://doi.org/10.1007/s11748-018-1024-9

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  • DOI: https://doi.org/10.1007/s11748-018-1024-9

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