Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature.

Details

Serval ID
serval:BIB_CF2BBE6D8647
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature.
Journal
Journal of thrombosis and thrombolysis
Author(s)
Bernardo F., Nannoni S., Strambo D., Bartolini B., Michel P., Sirimarco G.
ISSN
1573-742X (Electronic)
ISSN-L
0929-5305
Publication state
Published
Issued date
11/2019
Peer-reviewed
Oui
Volume
48
Number
4
Pages
679-684
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Efficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) due to intracranial artery dissection (IAD) are currently not established. We aimed to present a single-center experience on IAD-related AIS treated by IVT. We selected all consecutive patients with IAD-related AIS treated by IVT from a prospectively constructed single-center acute stroke registry from 2003 to 2017. We reviewed demographical, clinical and neuroimaging data and recorded hemorrhagic complications, mortality within 7 days and modified Rankin Scale at 3-months. Out of 181 AISs related to cervicocephalic dissections, 10 (5.5%) were due to IAD and five of these patients received IVT. Among these five patients, median age was 62 years; hypertension and dyslipidemia were the most frequent vascular risk factors. IAD locations were distal internal carotid artery, middle cerebral artery (M1), anterior cerebral artery (A2), and, in two cases, the basilar artery. All anterior circulation IADs were occlusive or subocclusive, while the two basilar artery IADs caused arterial stenosis. After IVT, there were no subarachnoid or symptomatic intracranial hemorrhages. One patient had an asymptomatic hemorrhagic infarct type 1. Two patients died within 7 days from ischemic mass effect. The other three patients had favorable clinical outcomes at 3-months. In this small single-center case series of IAD-related AIS, thrombolysis seemed relatively safe. However, IVT efficacy and the likelihood of arterial recanalization are still uncertain in this context. Further studies are needed to assess the safety and efficacy of IVT in these patients.
Keywords
Hematology, Cardiology and Cardiovascular Medicine, Acute ischemic stroke, Intracranial artery dissection, Intravenous thrombolysis, rtPA
Pubmed
Web of science
Create date
16/07/2019 13:49
Last modification date
05/01/2020 7:18
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