Tissue Plasminogen Activator to Treat a Stroke after Foam Sclerotherapy in a Woman with a Patent Foramen Ovale

J Stroke Cerebrovasc Dis. 2018 Jun;27(6):e110-e112. doi: 10.1016/j.jstrokecerebrovasdis.2018.01.001.

Abstract

Although foam sclerotherapy to varicose veins is now a popular treatment because of its high efficacy and safety, some neurologic complications have recently been reported. Presently, the effectiveness and safety of intravenous recombinant tissue-type plasminogen activator therapy to stroke following foam sclerotherapy remain unclear. Here, we report the case of a 68-year-old woman whose ischemic symptoms following foam sclerotherapy were treated by intravenous recombinant tissue-type plasminogen activator. After she was admitted, the venous thrombosis in her right soleus vein and a patent foramen ovale causing the right-to-left shunt were revealed. Thus, we diagnosed the ischemic symptoms were due to paradoxical embolism following foam sclerotherapy. After intravenous recombinant tissue-type plasminogen activator therapy, there was no complication and the outcome was good. Our case suggests the effectiveness and the safety of intravenous recombinant tissue-type plasminogen activator therapy to paradoxical embolism following foam sclerotherapy.

Keywords: paradoxical embolism; patent foramen ovale; polidocanol; rt-PA; sclerotherapy.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aged
  • Embolism, Paradoxical / drug therapy*
  • Embolism, Paradoxical / etiology
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Foramen Ovale, Patent / complications*
  • Foramen Ovale, Patent / therapy
  • Humans
  • Polidocanol
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins / therapeutic use
  • Sclerosing Solutions / adverse effects
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy / adverse effects*
  • Stroke / drug therapy*
  • Stroke / etiology
  • Tissue Plasminogen Activator / therapeutic use*
  • Varicose Veins / complications
  • Varicose Veins / therapy
  • Venous Thrombosis / complications
  • Venous Thrombosis / therapy

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols
  • Tissue Plasminogen Activator