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Intra-arterial tissue plasminogen activator for thrombosis complicating cerebral angiography in a 17-year-old girl. | LitMetric

AI Article Synopsis

  • * An immediate follow-up angiogram showed successful recanalization of the artery, and a later MRI confirmed that there was no brain tissue damage or infarction.
  • * Despite the successful treatment of the cerebral thrombosis, the girl experienced femoral artery thrombosis afterwards, and multiple treatments failed, ultimately resulting in a below-the-knee amputation, but her neurological function remained normal a year later.

Article Abstract

Few reports describe the use of intraarterial recombinant tissue plasminogen activator to treat intracranial thrombosis in children. A 17-year-old girl with a history of prior venous thrombosis developed a left middle cerebral artery thrombus during diagnostic cerebral angiogram. Therapy with intra-arterial tissue plasminogen activator was initiated. An immediate follow-up angiogram demonstrated recanalization, and diffusion-weighted magnetic resonance imaging 9 hours later showed no evidence of infarction. Following the angiogram, femoral artery thrombosis developed. Treatment with supratherapeutic levels of heparin, localized delivery of intra-arterial tissue plasminogen activator, embolectomy, danaparoid, and dipyridamole failed to re-establish perfusion to the lower leg, and below the knee amputation was required. Neurologic examination remained normal 1 year later. Cerebral damage was avoided with the use of emergency intra-arterial tissue plasminogen activator for cerebral artery thrombosis in this child.

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Source
http://dx.doi.org/10.1177/08830738030180060301DOI Listing

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