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Cerebral arterial gas embolism from attempted mechanical thrombectomy: recovery following hyperbaric oxygen therapy
  1. Louise Segan1,
  2. Fiona Permezel2,
  3. Wei Ch’ng3,
  4. Ian Millar3,4,
  5. Mark Brooks5,
  6. Matt Lee-Archer2,
  7. Geoffrey Cloud1,4
  1. 1Department of Stroke Services, Alfred Hospital, Melbourne, Victoria, Australia
  2. 2Department of Neurology, Austin Hospital, Heidelberg, Victoria, Australia
  3. 3Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Victoria, Australia
  4. 4Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
  5. 5Department of Interventional Radiology, Austin Hospital, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Louise Segan, Department of Stroke Services, Alfred Hospital, Melbourne, VIC 3004, Australia; louise.segan2{at}gmail.com

Abstract

Cerebral arterial gas embolism is a recognised complication of endovascular intervention with an estimated incidence of 0.08%. Its diagnosis is predominantly clinical, supported by neuroimaging. The treatment relies on alleviating mechanical obstruction and reversing the proinflammatory processes that contribute to tissue ischaemia. Hyperbaric oxygen therapy is an effective treatment and has multiple mechanisms to reverse the pathological processes involved in cerebral arterial gas embolism. Symptomatic cerebral arterial gas embolism is a rare complication of endovascular intervention for acute ischaemic stroke. Although there are no previous descriptions of its successful treatment with hyperbaric oxygen therapy following mechanical thrombectomy, this is likely to become more common as mechanical thrombectomy is increasingly used worldwide to treat acute ischaemic stroke.

  • stroke
  • cerebral blood flow
  • cerebrovascular disease
  • interventional

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Footnotes

  • Contributors All authors have contributed to the writing and editing of this manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by David Werring, London, UK.

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