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CASE REPORT
Year : 2017  |  Volume : 11  |  Issue : 4  |  Page : 1105-1108

Monitored anesthesia care for the acute ischemic stroke patient with end-stage pulmonary disease


1 Division of Oral and Maxillofacial Surgery, Columbia University, New York, NY, USA, India
2 Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA, India

Correspondence Address:
Kevin C Lee
Columbia University Medical Center, 630 West 168th Street, New York, NY 10032
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_95_17

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The majority of patients who suffer acute ischemic stroke (AIS) from large vessel occlusion are at a significant risk for disability or death. Because patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO) are therapeutically anticoagulated, intravenous recombinant tissue plasminogen activator is contraindicated. For AIS management, these patients must undergo emergent intra-arterial therapy. Presented is a patient on VA ECMO who subsequently suffered a large vessel embolic stroke requiring emergent surgical intervention. The decision by our anesthetic team to perform the procedure under monitored anesthesia care is discussed.


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