Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture

J Thromb Thrombolysis. 2020 Apr;49(3):497-498. doi: 10.1007/s11239-020-02067-x.

Abstract

First-line therapy of acute ischemic stroke is intravenous thrombolysis (IVT) irrespective of etiology. We report on a patient with acute ischemic stroke secondary to carotid plaque rupture who experienced plaque thrombosis and marked clinical worsening despite IVT. While the latter is the gold standard therapy optimal platelets inhibition should be guaranteed to allow a safe as possible carotid intervention. Hereby we discuss all available strategies to be considered in order to better individualized treatment decision-making.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aged
  • Carotid Arteries / diagnostic imaging*
  • Humans
  • Ischemic Stroke* / diagnostic imaging
  • Ischemic Stroke* / drug therapy
  • Ischemic Stroke* / etiology
  • Male
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / drug therapy
  • Thrombolytic Therapy*