Thrombolysis for Ischemic Stroke during Pregnancy: A Case Report and Review of the Literature

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• 作者：Steven Tversky ; DO ; Richard B. Libman ; MD ; Marina L. Reppucci ; BA ; Andrea M. Tufano ; BS ; Jeffrey M. Katz ; MD ; ^{JKatz2@Northwell.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Ischemic stroke ; pregnancy ; tPA ; alteplase ; thrombolysis
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：25
• 期：10
• 页码：e167-e170
• 全文大小：76 K

文摘

Our knowledge of the safety of thrombolytic therapy in pregnancy stems from individual case reports and series. We report the successful use of intravenous alteplase (tissue plasminogen activator; tPA) thrombolysis in a pregnant woman with acute cardioembolic stroke presumed to be paradoxical embolism through a patent foramen ovale.

id="absSec_2">Methods

id="sp0015">A literature review found several case reports and case series of pregnant patients treated with either intravenous or intra-arterial tPA for acute ischemic stroke.

id="absSec_3">Results

id="sp0020">A literature review yielded 10 cases of intravenous tPA administration and 5 cases of intra-arterial tPA. In total, there were 3 cases of asymptomatic intracerebral hemorrhage and 1 case of maternal and fetal death.

id="absSec_4">Conclusions

id="sp0025">Our patient improved clinically with no residual deficits. There was no evidence of placental or fetal injury following administration of tPA on follow-up obstetrical evaluations.