Case Report:Recombinant Tissue Plasminogen Activator Thrombolysis in Acute Ischemic Stroke First Case Report in Manipur

Abstract Background Intravenous recombinant tissue plasminogen activator is the only golden approved medical therapy for acute ischemic stroke, guidelines for its injection relay on reducing or preventing associated hemorrhage as a side effect, yet hemorrhage is not the only possible complication, further embolization following injection is also a possibility; in this case report, peripheral embolization following intravenous recombinant tissue plasminogen activator with two possible explanations one related to the treatment and another related to the patient liability is represented. Case presentation A 78-year-old male presenting with acute onset of stroke, received intravenous recombinant tissue plasminogen activator, 16 h later he developed acute limb ischemia. Conclusion Peripheral embolization may happen within hours from intravenous recombinant tissue plasminogen activator administration.

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Acute ischemic stroke in a 37-year-old pregnant woman successfully treated with recombinant tissue plasminogen activator and endovascular mechanical thrombectomy: A case report

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.3162 ◽

2017 ◽

Vol 381 ◽

pp. 1121-1122

Author(s):

T. Watanabe ◽

T. Kawaguchi ◽

S. Itaya ◽

M. Ichijo ◽

T. Amino ◽

...

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Pregnant Woman ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Mechanical Thrombectomy ◽

Recombinant Tissue Plasminogen Activator ◽

Tissue Plasminogen ◽

Endovascular Mechanical Thrombectomy

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Symptomatic Intracerebral Hemorrhage Among Eligible Warfarin-Treated Patients Receiving Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.03.014 ◽

2011 ◽

Vol 2011 ◽

pp. 10-11

Author(s):

A.A. Rabinstein

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Intravenous Tissue Plasminogen Activator ◽

Symptomatic Intracerebral Hemorrhage ◽

Tissue Plasminogen

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Faculty Opinions recommendation of Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718021390.793479381 ◽

2013 ◽

Author(s):

Patrick Ray

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Time To Treatment ◽

Intravenous Tissue Plasminogen Activator ◽

Tissue Plasminogen

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Faculty Opinions recommendation of Door-to-needle times for tissue plasminogen activator administration and clinical outcomes in acute ischemic stroke before and after a quality improvement initiative.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718359928.793530195 ◽

2017 ◽

Author(s):

Shyam Prabhakaran

Keyword(s):

Quality Improvement ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Clinical Outcomes ◽

Tissue Plasminogen Activator ◽

Quality Improvement Initiative ◽

Tissue Plasminogen ◽

Before And After

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Association of admission leukocyte count with clinical outcomes in acute ischemic stroke patients undergoing intravenous thrombolysis with recombinant tissue plasminogen activator

Current Neurovascular Research ◽

10.2174/1567202617999201125201616 ◽

2020 ◽

Vol 17 ◽

Author(s):

Jie Chen ◽

Fu-Liang Zhang ◽

Shan Lv ◽

Hang Jin ◽

Yun Luo ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Leukocyte Count ◽

Intravenous Thrombolysis ◽

Recombinant Tissue Plasminogen Activator ◽

Functional Independence ◽

Tissue Plasminogen ◽

Poor Outcomes

Objective:: Increased leukocyte count are positively associated with poor outcomes and all-cause mortality in coronary heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important. We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients. Methods:: This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of symptom onset between January 2016 and December 2018. We assessed outcomes including short-term hemorrhagic transformation (HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0–2 or 0–1). Results:: Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and 211 (36.4%) exhibited functional independence (mRS score: 0–2). Multivariable logistic regression revealed admission leukocyte count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3–6, odds ratio (OR): 1.076, 95% confidence interval (CI): 1.003–1.154, p=0.041) and 7.8% (mRS score: 2–6, OR: 1.078, 95% CI: 1.006–1.154, p=0.033). Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and lymphocyte count were not associated with 3-month functional outcomes or 3-month mortality. Conclusion:: Lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients undergoing rt-PA treatment.

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