Acute ischemic stroke in a 37-year-old pregnant woman successfully treated with recombinant tissue plasminogen activator and endovascular mechanical thrombectomy: A case report

Watanabe, T; Kawaguchi, Takumi; Itaya, Sakiko; Ichijo, Masahiko; Amino, Takeshi; Kamata, Tomoyuki

doi:10.1016/j.jns.2017.08.3162

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In current guidelines, pregnancy is considered a relative contraindication for acute stroke treatment [13]. Currently, there are only a few case reports and no data from controlled randomized trials concerning thrombolysis in combination with thrombectomy for stroke during pregnancy [10, 11, 12]. However, in a recent large stroke registry, pregnant or postpartum women were reported to have similarly favorable short-term outcome after reperfusion therapy (defined as thrombolysis, catheter-based thrombolysis, or thrombectomy either alone or in combination) as compared to nonpregnant women [5].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…For this group of patients, thrombectomy is a possible treatment option in case of large vessel occlusion [5]. To the best of our knowledge, there are only 3 published case reports, presenting the use of thrombolysis in combination with stent retrievers in pregnancy [10, 11, 12]. The 3 case reports demonstrated successful thrombectomy in all 3 cases without any serious complications of the procedure and beneficial outcome for the mother and child.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…In the recent years, a growing number of case reports demonstrating the beneficial use of thrombolysis in pregnant women with acute ischemic stroke have emerged. However, only 3 reports regarding thrombolysis in combination with endovascular therapy in stroke have been published [10, 11, 12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Ischemic Stroke in Late Pregnancy Treated with Intravenous Thrombolysis and Endovascular Therapy

E¹,

H²,

Modrau³

et al. 2019

Case Rep Neurol

View full text Add to dashboard Cite

Pregnancy has usually been an exclusion criterion in clinical trials with thrombolysis and endovascular therapy in acute ischemic stroke. For that reason, these therapies are not recommended causing lack of evidence and vice versa. In this case report, we describe a pregnant woman in week 33 + 3 presenting with acute ischemic stroke, which was successfully treated with systemic thrombolysis and endovascular therapy, resulting in a good clinical outcome for both mother and child. The altered fibrinolytic system and the risk factors related to pregnancy constitute a challenge for clinicians when choosing the most suitable treatment modality for treating acute ischemic stroke in pregnancy. It is still uncertain whether thrombolysis in combination with endovascular therapy or endovascular therapy alone is the most appropriate treatment option. However, there is slowly growing evidence that thrombolysis and thrombectomy in pregnancy are feasible and safe with a good clinical outcome for both the mother and the child.

show abstract

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Ischemic Stroke in Late Pregnancy Treated with Intravenous Thrombolysis and Endovascular Therapy

E¹,

H²,

Modrau³

et al. 2019

Case Rep Neurol

View full text Add to dashboard Cite

show abstract

Causes and Treatment of Acute Ischemic Stroke During Pregnancy

Terón

Eng

Katz

2018

Curr Treat Options Neurol

View full text Add to dashboard Cite

Intravenous tissue plasminogen activator (tPA) and endovascular thrombectomy have been used successfully to treat pregnant women with acute ischemic stroke. Recent national guidelines recommend considering tPA use during pregnancy for moderate and severe strokes if the potential benefits offset the risks of uterine hemorrhage. Pregnancy-associated ischemic stroke is rare, but can be devastating, and recanalization therapy should not be systematically withheld. Women who are at risk for stroke should be followed carefully, and providers caring for pregnant women should be educated regarding stroke signs and symptoms. Many of the standard post stroke diagnostic modalities may be used safely in pregnancy, and primary and secondary stroke prevention therapy must be tailored to avoid fetal toxicity.

show abstract