Massive pulmonary thromboembolism after intravenous stroke thrombolysis

Delgado, Montserrat González; Mauri, Gerard; Vega, Juan de la

doi:10.1136/bcr.10.2011.5008

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Unfortunately, the patients developed a lower extremity arterial embolism in a short period. There have been some reports of reembolism after intravenous thrombolysis in patients with AIS involving contralateral cerebral, coronary, pulmonary, and renal arteries [4][5][6]. The cases reported in the literature were similar to those presented by us, with satisfactory results of intravenous thrombolysis and rapid improvement in neurological function.…”

Section: Discussionsupporting

confidence: 64%

Lower extremity arterial embolism after intravenous thrombolysis for acute ischemic stroke

Xu,

Li,

Chen

2024

Preprint

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Background Early embolic events may be a rare complication following intravenous thrombolysis for acute ischemic stroke (AIS). Case presentation: We present two cases of lower extremity arterial embolism occurring shortly after intravenous thrombolysis. Both patients experienced acute occlusion of large arteries and atrial fibrillation and were diagnosed with cardioembolic stroke. The first case was a 49-year-old woman who presented with left limb paralysis. Thrombolysis with alteplase was performed, and five days later, she experienced a lower extremity arterial embolism. The second patient was a 64-year-old man who presented with right limb paralysis. Thrombolysis was performed, and three days later, he experienced a lower extremity arterial embolism. Conclusion Early embolic events may occur following intravenous thrombolysis for AIS, especially in patients with cardioembolic stroke; we should pay attention to this potential complication.

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Section: Discussionsupporting

confidence: 64%

Lower extremity arterial embolism after intravenous thrombolysis for acute ischemic stroke

Xu,

Li,

Chen

2024

Preprint

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“…15 One case suggested that a delay in the commencement of antithrombotic treatment after intravenous thrombolysis could have been a determinant of DVT. 16 According to the current guidelines put forth by the American Heart Association/ American Stroke Association, antiplatelet agents were started 24 h after thrombolysis, aiming to minimize the possibility of symptomatic intracranial hemorrhage, and early initiation of antiplatelet therapy may be considered under certain circumstances. 17 However, the trade-off between the risk of bleeding and the benefit of prophylaxis against DVTs using heparin, and the optimal time and dose to administer anticoagulants after thrombolysis require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Lower-Extremity Deep Vein Thrombosis After Thrombolysis Among Patients with Acute Ischemic Stroke

Liu

Guo

et al. 2021

PGPM

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Background: Deep vein thrombosis (DVT) is common among patients with stroke. However, the incidence of DVT in acute ischemic stroke patients treated with thrombolytic therapy and the risk factors associated with this condition are unknown. Objective: This study aimed to investigate the incidence and risk factors of DVT after thrombolysis in patients with acute ischemic stroke. Settings and Methods: We retrospectively reviewed the medical records of all patients with acute ischemic stroke who underwent ultrasonic examination after intravenous thrombolysis between April 2017 and December 2019 at the stroke center of the First Hospital of Jilin University, China. Color duplex ultrasound was used to diagnosis DVT in all patients within 72 h after intravenous thrombolysis. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for DVT. Results: Overall, 474 patients were included in the study. Of these, 75 (15.8%) developed DVT (95% confidence interval 12.5-19.1). Older age was the risk factor that most significantly affected the development of DVT (p = 0.001). Compared to patients younger than 60 years old, those aged 60-69 years and ≥70 years had a higher risk of DVT, at rates of 2.201 (95% CI: 1.033-4.689; p < 0.05) and 4.241 (95% CI: 2.016-8.922; p < 0.001) times higher, respectively. Patients with higher triglyceride levels (odds ratio 0.545, 95% CI: 0.372-0.799, p = 0.002) and longer activated partial thromboplastin time (OR 0.927, 95% CI: 0.862-0.996, p = 0.040) were less likely to have DVT. Conclusion:DVT is a common complication among patients undergoing intravenous thrombolysis after acute ischemic stroke. Advanced age may increase the occurrence of DVT to some extent. For these patients, safe antiplatelet therapy should be explored and implemented as soon as possible.

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Clinical conundrum: concomitant high-risk pulmonary embolism and acute ischemic stroke

et al. 2020

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Massive pulmonary thromboembolism after intravenous stroke thrombolysis

Cited by 4 publications

References 6 publications

Lower extremity arterial embolism after intravenous thrombolysis for acute ischemic stroke

Lower extremity arterial embolism after intravenous thrombolysis for acute ischemic stroke

Incidence and Risk Factors of Lower-Extremity Deep Vein Thrombosis After Thrombolysis Among Patients with Acute Ischemic Stroke

Clinical conundrum: concomitant high-risk pulmonary embolism and acute ischemic stroke

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