Case Of Intravenous Thrombolysis Research Articles

Reversal of the Anticoagulation Effects of Dabigatran Etexilate by Idarucizumab in Three Patients Needing Urgent Surgical Intervention and One Case of Intravenous Thrombolysis in Ischaemic Stroke.

ObjectiveTo describe the benefits of reversal of the anticoagulation effects of dabigatran etexilate in patients requiring urgent surgery or thrombolysis for ischaemic stroke.Materials and methodsFour patients, treated with dabigatran etexilate and presenting with cholecystitis, tibial fracture, lower limb ischaemia and ischaemic stroke, respectively.Results Administration of idarucizumab normalized bleeding parameters and provided safe conditions for surgery and, in one case, successful thrombolysis of an ischaemic stroke.Conclusion The introduction of an effective reversal agent for dabigatran etexilate allows physicians perform surgery under conditions of normal coagulation and permits thrombolysis in patients with ischaemic stroke despite being treated with dabigatran etexilate.LEARNING POINTSNovel oral anticoagulants (NOACs) are a safe alternative to warfarin to prevent ischaemic stroke.Ability to reverse the anticoagulant effects of NOACs could increase adherence to anticoagulation therapy, thereby decreasing the risk of ischaemic stroke.Reversal of the anticoagulant effect of dabigatran etexilate can improve the outcome in patients needing urgent surgery, intervention and thrombolysis.

One successful case of intravenous thrombolysis during cardiopulmonary resuscitation in acute myocardial infarction with 89 defibrillations

One successful case of intravenous thrombolysis during cardiopulmonary resuscitation in acute myocardial infarction with 89 defibrillations

First Thrombolysis in Acute Stroke with Tenecteplase in Congo

Thrombolysis in acute ischemic stroke remains the only effective treatment. Alteplase or recombinant tissue Plasminogen Activator (rt-PA) is the only drug approved and widely used. The use of tenecteplase is still studied (1,2). In subSaharan Africa, many patients, although eligible for thrombolysis, do not benefit for many reasons including accessibility to medical imaging, the lack of stroke unit, and the cost of thrombolytic drug. We report the first Congolese case of intravenous thrombolysis, using tenecteplase.

Intra-Arterial Thrombolysis of a Distal Internal Carotid Artery Occlusion in an Adolescent

This article describes the first reported case of an adolescent being treated with intra-arterial urokinase for a distal internal carotid artery occlusion. A 15-year-old male presenting with an acute ischemic stroke caused by a distal internal carotid artery occlusion was treated with intra-arterial urokinase at 5 hours and 45 minutes after symptom onset. The artery completely recanalized, and the patient improved significantly from an admission National Institutes of Health Stroke Scale (NIHSS) score of 28 to a NIHSS score of 8 at a 2.5-month follow-up, despite an asymptomatic intraparenchymal hemorrhage. This article reviews the only two reported cases of intravenous thrombolysis and three cases of intra-arterial thrombolysis in children with ischemic stroke and suggests that thrombolytic therapy should be considered a treatment option in selected pediatric patients with stroke, especially in adolescents who are generally treated as young adults.