Place de la thrombectomie mécanique dans l'AVC ischémique en période postopératoire

Reduction of functional disablity after acute ischemic stroke requires a fast and complete recanalization of the target cerebral artery. Mechanical thrombectomy has a 70% success rate for recanalization, and improves significantly the clinical outcome, compared to the thrombolysis alone. Thrombolysis cannot be administered in the setting of post-operative period due to the high risk of bleeding, but thrombectomy is validated in the subset of stroke patients with large vessel occlusion. In case of post-operative neurological deficit, a brain imaging must be performed urgently, including intracranial arterial acquisition, and thrombectomy must be considered as soon as possible in case of large vessel occlusion (internal carotid artery and/or the middle cerebral artery).