Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA).
Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.
Sharma
V K
VK
Department of Neurology, Barrow Neurological Institute, Phoenix, AZ 85013, USA. drvijay@singnet.com.sg
Tsivgoulis
G
G
Lao
A Y
AY
Flaster
M
M
Frey
J L
JL
Malkoff
M D
MD
Alexandrov
A V
AV
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002545:Brain Ischemia / Q000209:etiology*; D002341:Carotid Artery Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D017536:Carotid Artery, Common; D002533:Cerebral Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009420:Nervous System / Q000187:drug effects / Q000503:physiopathology; D020127:Recovery of Function; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator