title: [Intra-arterial thrombolysis of a basilar vascular accident during coronary angiography].
abstract: The authors report the case of a 67 year old man with a previous history of aortobifemoral arterial graft who had unstable angina after carotid endarterectomy. Coronary angiography by the right brachial artery was complicated by a cerebrovascular accident with a reactive coma, convulsions and respiratory problems. Selective angiography of the right vertebral artery showed an image of occlusive thrombosis of the basilar artery. In view of the clinical state and angiographic appearances, the authors decided on immediate intra-arterial thrombolysis with Urokinase which dissolved the clot and reestablished flow in the basilar artery, the cerebellar and posterior cerebral arteries. The outcome was favourable with immediate and good recovery of consciousness and hospital discharge on the sixth day without neurological or radiological sequellae. Cerebrovascular accident is a rare and potentially serious complication of left heart catheterisation which requires immediate cerebral angiography to determine the mechanism and propose an appropriate therapeutic approach.
authors.affiliation: Service de cardiologie de l'institut catholique de Lille.
authors.forename: K
authors.initials: K
authors.lastname: Battikh
authors.forename: R
authors.initials: R
authors.lastname: Rihani
authors.forename: J M
authors.initials: JM
authors.lastname: Lemahieu
authors.forename: M
authors.initials: M
authors.lastname: Mokahal
authors.forename: Z
authors.initials: Z
authors.lastname: Houchaymi
authors.forename: P
authors.initials: P
authors.lastname: Cornaert
authors.forename: A
authors.initials: A
authors.lastname: Dutoit
mesh_terms: D000368:Aged; D000789:Angina, Unstable; D001488:Basilar Artery / Q000473:pathology*; D003128:Coma / Q000209:etiology; D017023:Coronary Angiography / Q000009:adverse effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D010960:Plasminogen Activators / Q000008:administration & dosage* / Q000627:therapeutic use*; D020521:Stroke / Q000209:etiology* / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use*
chemical_list: D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator
vernacular_title: Thrombolyse intra-artérielle d'un accident vasculaire basilaire au cours de la coronarographie.