Intravenous thrombolysis in a stroke patient with a repaired aortic dissection

BMJ Case Rep. 2024 Dec 18;17(12):e262995. doi: 10.1136/bcr-2024-262995.

Abstract

Acute aortic dissection is considered a contraindication to the use of intravenous thrombolysis in patients presenting with acute ischaemic stroke, but less has been described about previously repaired dissections. We present a case of a woman in her 50s presenting with acute left hemiparesis with a known history of aortic dissection within the thrombolysis window. After multidisciplinary discussion with cardiothoracic surgery and discussion with the patient, she was treated with intravenous thrombolysis without complication. In patients with previously repaired aortic dissection without evidence of redissection, intravenous thrombolysis can be considered.

Keywords: Cardiovascular medicine; Neurology; Stroke.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aortic Dissection* / complications
  • Aortic Dissection* / surgery
  • Female
  • Fibrinolytic Agents* / administration & dosage
  • Fibrinolytic Agents* / therapeutic use
  • Humans
  • Ischemic Stroke / drug therapy
  • Ischemic Stroke / surgery
  • Middle Aged
  • Stroke / drug therapy
  • Stroke / etiology
  • Thrombolytic Therapy* / methods
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator