Successful Tissue Plasminogen Activator for a Patient with Stroke After Stanford Type A Aortic Dissection Treatment

J Stroke Cerebrovasc Dis. 2018 Jul;27(7):e132-e134. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.023. Epub 2018 Mar 7.

Abstract

Some stroke patients with the acute aortic dissection receiving thrombolysis treatment resulted in fatalities. Thus, the concurrent acute aortic dissection is the contraindication for the intravenous recombinant tissue-type plasminogen activator. However, the safety and the effectiveness of the intravenous recombinant tissue-type plasminogen activator therapy are not known in patients with stroke some days after acute aortic dissection treatment. Here, we first report a case of a man with a cardioembolism due to the nonvalvular atrial fibrillation, who received the intravenous recombinant tissue-type plasminogen activator therapy 117 days after the traumatic Stanford type A acute aortic dissection operation. Without the intravenous recombinant tissue-type plasminogen activator therapy, the prognosis was expected to be miserable. However, the outcome was good with no complication owing to the intravenous recombinant tissue-type plasminogen activator therapy. Our case suggests the effectiveness and the safety of the intravenous recombinant tissue-type plasminogen activator therapy to the ischemic stroke some days after acute aortic dissection treatment.

Keywords: NVAF; Stanford type A; aortic dissection; rt-PA; stroke.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aged, 80 and over
  • Aortic Dissection / complications
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / surgery*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / surgery
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / drug therapy*
  • Recombinant Proteins / therapeutic use
  • Stroke / diagnostic imaging
  • Stroke / drug therapy*
  • Stroke / etiology*
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use*

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator