Intravenous thrombolysis in patient with vertebrobasilar dolichoectasia and antiplatelet medication

Sari, Pipit Mei; Sani, Achmad Firdaus; Kurniawan, Dedy

doi:10.1016/j.radcr.2022.06.061

Cited by 1 publication

(7 citation statements)

References 23 publications

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“…After the thorough evaluation, a total of seven studies were identified that met all the predefined criteria and were included in the analysis. 55 , 56 , 57 , 58 , 59 , 60 , 61 These studies satisfied the inclusion criteria regarding patient characteristics, therapeutic window, neurological deficit assessment, and treatment approaches.…”

Section: Resultsmentioning

confidence: 99%

“…They presented a case of a patient with acute ischemic stroke and limited access, successfully treated through direct cervical access, demonstrating the feasibility of this technique in overcoming access limitations. Sari et al 61 examined the impact of vertebrobasilar dolichoectasia (VBD) on IVT therapy in patients with acute stroke. They described a case involving a patient with a history of antiplatelet use and concomitant VBD who received prompt IVT, leading to a substantial improvement in neurological symptoms.…”

Section: Resultsmentioning

confidence: 99%

“…In the analyzed records, this therapy was used in three cases: 56, 58, and 61. 58,61 Thrombolytic treatment significantly improved the neurological symptoms of the patients without hemorrhagic complications, resulting in a decrease of 6 and 5 points, respectively, in the NIHSS score. In a case, endovascular popliteal thrombectomy was necessary on Day 4 of stroke onset due to the identification of arterial occlusion in the lower right extremity, the timing of which was unknown.…”

Section: Discussionmentioning

confidence: 97%

“…Thrombolysis is an effective technique in the treatment of acute ischemic stroke but can also increase the risk of intracranial hemorrhage. In the analyzed records, this therapy was used in three cases: 56, 58, and 61 58,61 . Thrombolytic treatment significantly improved the neurological symptoms of the patients without hemorrhagic complications, resulting in a decrease of 6 and 5 points, respectively, in the NIHSS score.…”

Section: Discussionmentioning

confidence: 99%

“…In a case, endovascular popliteal thrombectomy was necessary on Day 4 of stroke onset due to the identification of arterial occlusion in the lower right extremity, the timing of which was unknown 58 . In a reference, stenosis in the M1 and M2 regions of the right middle cerebral artery was observed 1 h after thrombolysis administration 61 . In reference numbered 57, 59, and 60, MT was performed using stents, in which patients were contraindicated for thrombolysis for various reasons 57,59,60 .…”

Section: Discussionmentioning

confidence: 99%

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Hemiplegia in acute ischemic stroke: A comprehensive review of case studies and the role of intravenous thrombolysis and mechanical thrombectomy

Carrillo Navarrete,

Chapa González

2024

Ibrain

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Acute ischemic stroke is a significant health concern worldwide, often leading to long‐term disability and decreased quality of life. Rapid and appropriate treatment is crucial for achieving optimal outcomes in these patients. Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are two commonly used interventions for acute ischemic stroke, but their effectiveness in improving neurological symptoms and functional outcomes in patients with hemiplegia remains uncertain. The aim of this work was to evaluate the impact of IVT and MT within a 4.5‐h time frame on patients with acute ischemic stroke and hemiplegia. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Relevant studies that assessed the impact of IVT and MT within 4.5‐h on hemiplegia in patients with an acute ischemic stroke were included. Data were extracted and analyzed to determine the overall effects of these interventions. Most included case reports indicate positive outcomes in terms of neurological symptom improvement and functional recovery in patients with hemiplegia after receiving IVT and MT within the specified time frame. However, the heterogeneity among the patients and the limited use of IVT due to contraindications posed challenges in determining the most effective treatment option. The findings from the included studies demonstrate that both interventions led to a decrease in National Institutes of Health Stroke Scale scores, indicating an improvement in neurological symptoms. The results highlight the beneficial effects of early thrombolytic interventions and MT on the neurological status and functional outcomes of patients with an acute ischemic stroke.

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