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

dc.contributor.authorBernardo, F
dc.contributor.authorNannoni, S
dc.contributor.authorStrambo, D
dc.contributor.authorBartolini, B
dc.contributor.authorMichel, P
dc.contributor.authorSirimarco, G
dc.date.accessioned2019-12-16T16:42:41Z
dc.date.available2019-12-16T16:42:41Z
dc.date.issued2019
dc.description.abstractEfficacy 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Thromb Thrombolysis. 2019 Nov;48(4):679-684pt_PT
dc.identifier.doi10.1007/s11239-019-01918-6.pt_PT
dc.identifier.issn1573-742X
dc.identifier.urihttp://hdl.handle.net/10400.10/2356
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAcute ischemic strokept_PT
dc.subjectCerebral revascularizationpt_PT
dc.subjectArterial occlusive diseasespt_PT
dc.titleIntravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literaturept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceDordrechtpt_PT
oaire.citation.titleJournal of Thrombosis and Thrombolysispt_PT
rcaap.rightsclosedAccesspt_PT
rcaap.typearticlept_PT

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