A 60-year-old man on ICU develops new left-sided weakness (MRC 2/5 in left arm and leg) and neglect 6 hours after an emergency CABG. CT head shows no ...

Question

A 60-year-old man on ICU develops new left-sided weakness (MRC 2/5 in left arm and leg) and neglect 6 hours after an emergency CABG. CT head shows no haemorrhage. CT angiography shows right MCA occlusion. His NIHSS is 16. He is on therapeutic heparin for the bypass circuit. Is thrombolysis appropriate?

Accepted Answer

No - IV thrombolysis is contraindicated within 7 days of major surgery (CABG); however, mechanical thrombectomy should be considered urgently as it does not carry the same systemic bleeding risk and can be performed in patients with contraindications to thrombolysis

Answer

Yes - standard thrombolysis protocol

Answer

No treatment is available

Answer

Start oral aspirin only

Answer

Increase the heparin dose

uk-fficm MCQ (SBA): Stroke - Thrombectomy Post-Surgery