Intravascular Mechanical Thrombectomy for a Patient with Systemic Lupus Erythematosus and Acute Cerebral Infarction with Antiphospholipid Syndrome

Systemic lupus erythematosus (SLE) is a diffuse connective tissue disease that is characterized by autoimmune-mediated inflammation. Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease. A 55-year-old female patient was admitted to the hospital due to ‘sudden speech insufficiency and aggravation of 5 h’. The patient developed sudden dizziness, facial numbness, and slurred speech and was transported to the emergency department in a local hospital, and was diagnosed ‘cerebral infarction’ after a CT examination. According to the medical records, the patient developed SLE at the age of 25. CT showed low density lesions of the left pons and occipital lobe; emergent MRI showed bilateral infarction in the cerebellum and brainstem, and magnetic resonance angiography (MRA) showed upper basilar artery occlusion. Ischemic stroke was diagnosed and NIHSS scored 30. The occluded artery was successfully recanalized with endovascular mechanical thrombectomy. Modified thrombolysis in cerebral infarction (mTICI) blood flow perfusion grade was grade 3. The case is the first one in the literature that acute ischemic stroke related to SLE vasculitis and antiphospholipid syndrome was treated successfully with endovascular mechanical thrombectomy.