2000
DOI: 10.1212/wnl.54.8.1684
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Intra-arterial thrombolysis for the treatment of perioperative childhood cardioembolic stroke

Abstract: Local intra-arterial lysis using recombinant tissue plasminogen activator (rTPA) was performed in a 6 and 2/3-year-old patient with major cardioembolic ischemic stroke 48 hours after intracardiac surgery. Selective application of 2.5 mg rTPA (0.11 mg/kg body weight) resulted in recanalization of the occluded cerebral vasculature with good neurologic recovery.

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Cited by 65 publications
(36 citation statements)
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“…There have been several small reports and series of children receiving thrombolytic therapy. [3][4][5][6][7][8][9][10][11] Most involved cases of intra-arterial delivery of thrombolytic (urokinase, tissue plasminogen activator) with varying stroke etiologies, treatment windows, dosages and outcome measures, though largely the immediate results were favorable. Mode of delivery could also not be ascertained, though it is possible that the patients who underwent cerebral angiography on the incident stroke day did so for the purposes of intra-arterial delivery of thrombotics.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…There have been several small reports and series of children receiving thrombolytic therapy. [3][4][5][6][7][8][9][10][11] Most involved cases of intra-arterial delivery of thrombolytic (urokinase, tissue plasminogen activator) with varying stroke etiologies, treatment windows, dosages and outcome measures, though largely the immediate results were favorable. Mode of delivery could also not be ascertained, though it is possible that the patients who underwent cerebral angiography on the incident stroke day did so for the purposes of intra-arterial delivery of thrombotics.…”
Section: Discussionmentioning
confidence: 99%
“…Thrombolytic therapies have been shown to be safe and effective in adults, but there is no data in the population below 18 years of age. There are several reports of intravenous and intra-arterial thrombolysis among children, [3][4][5][6][7][8][9][10][11] but national estimates are unknown. We sought to determine rates of thrombolysis for pediatric ischemic stroke as well as associated demographic and clinical data, and compare these between children who did and did not receive thrombolysis in a national government sponsored database.…”
mentioning
confidence: 99%
“…81,82,83,84,85 In adults the absolute risk reduction for poor outcome is approximately 15% with thrombolysis, with a number needed to treat of 7-8 in the largest RCCT. 86 Careful patient selection and adherence to protocol are critical to optimize the risk:benefit balance of thrombolytic therapy in adults 87,88 but no studies in pediatric stroke have been completed..…”
Section: Hyperacute Treatment: Thrombolysismentioning
confidence: 99%
“…Safe and successful acute thrombolysis in children has been reported with the use of the recombinant tissue plasminogen activator (rtPA) alteplase within 3 hours after the onset of symptoms. 3,4 The use of local or systematic thrombolytic agents, including urokinase, streptokinase and rtPA, in children was associated with bleeding complications in 10% to 20% of cases and intracranial hemorrhage in 1% to 2%. 5 The risk of intracerebral hemorrhage associated with the use of alteplase in pediatric stroke is currently unknown.…”
Section: P R Ac T I C Ementioning
confidence: 99%