Background

Acute ischemic stroke (AIS) has a high risk of recurrence, particularly in the early stage. Recurrent ischemic stroke (RIS) is associated with adverse neurological outcomes but the phenomenon of early RIS in the endovascular thrombectomy era has not been frequently discussed. We report a case addressing this issue.

Case presentation

We present a patient who was successfully treated by mechanical thrombectomy (MT) for middle cerebral artery occlusion. Due to an early stroke recurrence, within 72 h after the first MT, he received systemic thrombolysis and repeated MT was performed with excellent clinical outcome.

Discussion

We discuss the aspects of reperfusion therapy for patients experiencing early stroke recurrence. Consideration was given to stroke etiology and off-label use of thrombolytic therapy. Also, effectiveness of repeated MT for early re-occlusion of initially reanalyzed vessel was evaluated in order to allow more patients with RIS to benefit from reperfusion therapy.

中文翻译：

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缺血性卒中早期复发患者的再灌注治疗

背景

急性缺血性卒中 (AIS) 具有很高的复发风险，尤其是在早期阶段。复发性缺血性卒中 (RIS) 与不良的神经系统结果相关，但血管内血栓切除术时代的早期 RIS 现象尚未经常讨论。我们报告了一个案例来解决这个问题。

案例展示

我们介绍了一位通过机械取栓 (MT) 成功治疗大脑中动脉闭塞的患者。由于早期卒中复发，在第一次 MT 后 72 小时内，他接受了全身溶栓，并进行了多次 MT，临床结果良好。

讨论

我们讨论了早期卒中复发患者再灌注治疗的各个方面。考虑了中风病因和溶栓治疗的超适应症使用。此外，为了让更多的 RIS 患者受益于再灌注治疗，还评估了重复 MT 对早期重新分析血管早期再闭塞的有效性。