title: Angioedema in the neurointerventional suite.
abstract: A 68-year-old woman with acute ischemic stroke presented for mechanical thrombectomy, after failed thrombolysis with intravenous recombinant tissue plasminogen activator. The procedure was completed successfully with dexmedetomidine infusion. However, she developed acute angioedema toward the end of the procedure requiring emergent fiberoptic-guided endotracheal intubation. Angioedema has been reported to occur after administering intravenous recombinant tissue plasminogen activator with an incidence of 1.3%-5.1% in patients with acute stroke.
authors.affiliation: General Anesthesiology and Department of Outcomes Research, Cleveland Clinic, Cleveland, OH. Electronic address: sonnya@ccf.org.
authors.forename: Abraham
authors.initials: A
authors.lastname: Sonny
authors.affiliation: General Anesthesiology, Cleveland Clinic, Cleveland, OH. Electronic address: avitsir@ccf.org.
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
authors.affiliation: Vascular Neurology and Endovascular Surgical Neuroradiology, Cleveland Clinic, Cleveland, OH. Electronic address: hussais4@ccf.org.
authors.forename: M Shazam
authors.initials: MS
authors.lastname: Hussain
authors.affiliation: General Anesthesiology and Department of Outcomes Research, Cleveland Clinic, Cleveland, OH. Electronic address: elsharh@ccf.org.
authors.forename: Hesham
authors.initials: H
authors.lastname: Elsharkawy
mesh_terms: D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced / Q000000981:diagnostic imaging; D011994:Recombinant Proteins / Q000009:adverse effects; D020521:Stroke / Q000628:therapy*; D017131:Thrombectomy; D015912:Thrombolytic Therapy / Q000009:adverse effects* / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: Angioedema; Neurointerventional suite; Recombinant tissue plasminogen activator; Sedation; Stroke