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Neurocrit Care. 2005;3(1):54-6.

Recurrent artery-to-artery embolism during intravenous t-PA therapy for acute ischemic stroke.

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1
Ken and Ruth Davee Department of Neurology and Clinical Neurological Sciences, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA.

Abstract

INTRODUCTION:

Treatment of acute ischemic stroke with systemic thrombolysis in the presence of a proximal thrombo-embolic source carries a theoretical risk of thrombus fragmentation and recurrent embolization. Intracardiac thrombus has received the most attention as a potential source of recurrent emboli, and in the past, it was considered a relative contra-indication to tissue plaminogen activator (t-PA) treatment. More recent data show that recurrent embolization from a cardiac source during t-PA infusion is rare.

CASE REPORT:

This article describes recurrent symptomatic basilar artery embolization during t-PA infusion from acute thrombus in the proximal cervical vertebral artery.

DISCUSSION:

This case provides evidence that intravenous t-PA must be used cautiously in the presence of large proximal thrombo-embolic sources and that intraluminal thrombus in a large cervical artery should be considered one such source.

PMID:
16159096
DOI:
10.1385/NCC:3:1:054
[Indexed for MEDLINE]
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