Intraprocedural Thromboembolism From Infective Endocarditis With Immediate Endovascular Mechanical Thrombectomy: A Case of Remarkable Timing

Infectious intracranial aneurysms and embolic strokes are common neurological complications in patients with infective endocarditis. Diagnostic cerebral angiograms are often performed prior to cardiac valve repair if an infectious intracranial aneurysm or intracranial hemorrhage is suspected. We report a unique case of a patient with endocarditis who experienced an embolic stroke that resulted in large-vessel occlusion (LVO) of the middle cerebral artery during a diagnostic cerebral angiogram. Upon detection of the intraprocedural LVO, endovascular mechanical thrombectomy (EVT) was immediately performed using a stent retriever and the contact aspiration technique. To our knowledge, this case is unique in both its pathology and remarkable timing. This case provides further evidence supporting the efficacy of EVT for treating LVO secondary to infective endocarditis.