Primeira trombectomia mecânica em gestante no Brasil
First mechanical thrombectomy in a pregnant woman in Brazil
DOI:
https://doi.org/10.34119/bjhrv5n5-302Keywords:
Trombectomia Mecânica (TM), Trombose Gestacional, gravidez de alto risco, AVC na gestação, Trombose Venosa Cerebral (TVC)Abstract
Durante a gestação, o risco de ocorrência de Acidente Vascular Cerebral (AVC) aumenta entre cinco e dez vezes quando comparado ao de mulheres não gestantes de mesma idade. O risco de AVC parece variar durante os diferentes estágios da gravidez, sendo que foi observada maior frequência de infartos no 3º trimestre, com pico na 1ª semana pós-parto, mas com risco persistente durante as 6 primeiras semanas do puerpério. Esse relato de caso apresenta a primeira Trombectomia Mecânica (TM) realizada no Brasil em gestante que sofreu AVC, e visa enriquecer a discussão sobre as evidências de tratamento com TM durante o período gestacional, que carece de evidências científicas.
References
- Diretriz de AVC do Brasil. Ministério da Saúde.
- DE SOUZA, M. et al. Diretriz Assistencial Multidisciplinar de Abordagem ao Paciente com Acidente Vascular Cerebral. Traducao . Vitória/ES, 2018.
- CABRAL, N. et al. Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional. Arquivos de Neuro-Psiquiatria, v. 55, n. 3A, p. 357-363, 1997.
- MORIYAMA, TAKUYA, SUGIURA, YURIHAYASHI, YUTO et al. Thrombolysis and Mechanical Thrombectomy for Acute Ischemic Stroke in Pregnancy: A Case Report. Journal of Neuroendovascular Therapy, v. 15, n. 2, p. 124-128, 2021.
- SWARTZ, RICHARD H, CAYLEY, MEGAN LFOLEY, NORINE et al. The incidence of pregnancy-related stroke: A systematic review and meta-analysis. International Journal of Stroke, v. 12, n. 7, p. 687-697, 2017.
- RODRIGUES, R. et al. Acute Ischemic Stroke in Pregnancy. Case Reports in Neurology, v. 11, n. 1, p. 37-40, 2019.
- KLEINDORFER, D. et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke, v. 52, n. 7, 2021.
- DICPINIGAITIS, A. et al. Endovascular Thrombectomy for Treatment of Acute Ischemic Stroke During Pregnancy and the Early Postpartum Period. Stroke, v. 52, n. 12, p. 3796-3804, 2021.
- TSE, GEORGE H., BALIAN, VARTANCHARALAMPATOU, PARASKEVI et al. Foetal radiation exposure caused by mechanical thrombectomy in large-vessel ischaemic stroke in pregnancy. Neuroradiology, v. 61, n. 4, p. 443-449, 2019.
- WATANABE, TOSHIYUKI TONY, ICHIJO, MASAHIKOKAMATA, TOMOYUKI. Uneventful Pregnancy and Delivery after Thrombolysis PlusThrombectomy for Acute Ischemic Stroke: Case Study and Literature Review. Journal of Stroke and Cerebrovascular Diseases, v. 28, n. 1, p. 70-75, 2019.
- BHOGAL, PERVINDER, AGUILAR, MARTALMATTER, MUHAMMAD et al. Mechanical Thrombectomy in Pregnancy: Report of 2 Cases and Review of the Literature. Interventional Neurology, v. 6, n. 1-2, p. 49-56, 2017.
- POWERS, W. et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, v. 50, n. 12, 2019.
- PONTES-NETO, OCTÁVIO MARQUES, COUGO, PEDROMARTINS, SHEILA CRISTINA OURIQUES et al. Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke. Arquivos de Neuro-Psiquiatria, v. 75, n. 1, p. 50-56, 2017.
- LEWIS, GWYNETH. Saving mothers' lives. London: CEMACH, 2007.
- LINDQVIST, P. Thrombotic risk during pregnancy: a population study. Obstetrics & Gynecology, v. 94, n. 4, p. 595-599, 1999.
- LIU, SHILIANG, ROULEAU, JOCELYNJOSEPH, K.S. et al. Epidemiology of Pregnancy-associated Venous Thromboembolism: A Population-based Study in Canada. Journal of Obstetrics and Gynaecology Canada, v. 31, n. 7, p. 611-620, 2009.
- LEFFERT, L. et al. Treatment patterns and short-term outcomes in ischemic stroke in pregnancy or postpartum period. American Journal of Obstetrics and Gynecology, v. 214, n. 6, p. 723.e1-723.e11, 2016.
- DEL ZOPPO, G. et al. Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Annals of Neurology, v. 32, n. 1, p. 78-86, 1992.
- SAQQUR, M. et al. Site of Arterial Occlusion Identified by Transcranial Doppler Predicts the Response to Intravenous Thrombolysis for Stroke. Stroke, v. 38, n. 3, p. 948-954, 2007.
- BHATIA, R. et al. Low Rates of Acute Recanalization With Intravenous Recombinant Tissue Plasminogen Activator in Ischemic Stroke. Stroke, v. 41, n. 10, p. 2254-2258, 2010.
- ALEXANDER, MATHEW, AARON, SANJITHSHYAMKUMAR, NK et al. Mechanical thrombectomy for acute ischemic stroke in pregnancy using the penumbra system. Annals of Indian Academy of Neurology, v. 19, n. 2, p. 261, 2016.
- FISHER, M.; GINSBERG, M. Current Concepts of the Ischemic Penumbra. Stroke, v. 35, n. 11_suppl_1, p. 2657-2658, 2004.
- SAVER, J. Time Is Brain—Quantified. Stroke, v. 37, n. 1, p. 263-266, 2006.
