Repeated Intravenous Thrombolysis in Patients with Recurrent Ischemic Stroke in the Vertebrobasilar Territory

David Černík; Dušan Ospalík; Daniel Šaňák; Filip Cihlář

doi:10.1159/000518193

Repeated Intravenous Thrombolysis in Patients with Recurrent Ischemic Stroke in the Vertebrobasilar Territory

Case Rep Neurol. 2021 Jul 29;13(2):510-514. doi: 10.1159/000518193. eCollection 2021 May-Aug.

Authors

David Černík¹, Dušan Ospalík¹, Daniel Šaňák², Filip Cihlář³

Affiliations

¹ Department of Neurology, Comprehensive Stroke Center, Masaryk Hospital Ústí nad Labem, KZ a.s., Ústí nad Labem, Czechia.
² Department of Neurology, Comprehensive Stroke Center, Palacký University Medical, School and Hospital, Olomouc, Czechia.
³ Department of Radiology, Masaryk Hospital, Faculty of Health Studies, J.E. Purkinje University, KZ a.s., Ústí nad Labem, Czechia.

Abstract

Acute ischemic vertebrobasilar stroke (AIVBS) is usually associated with poor outcome and prognosis and in case of basilar artery occlusion (BAO) with high mortality. Intravenous thrombolysis (IVT), as a standard recanalization therapy of acute ischemic stroke (IS) within first 4.5 h, can be administrated beyond this therapeutic time window in case of symptomatic BAO. Repeated IVT is generally contraindicated in case of early recurrent IS, despite a risk of poor outcome or death after recurrent IS. The aim was to present 2 cases of repeated IVT for recurrent AIVBS and discuss specific situations where repeated IVT may be considered. Up to now, repeated IVT has been reported only in recurrent stroke in anterior circulation.

Keywords: Basilar artery occlusion; Eptifibatide; Ischemic stroke; Repeated intravenous thrombolysis.

Publication types

Case Reports