title: Emergency Superficial Temporal Artery to Middle Cerebral Artery Bypass After Intravenous Administration of Tissue Plasminogen Activator for Stroke.
abstract: Intravenous tissue plasminogen activator (IVtPA) is effective for the treatment of acute stroke. Although IVtPA is easily administered and is effective in many cases, the clinical condition of some patients can worsen after the initiation of thrombolytic therapy due to sustained cerebrovascular insufficiency. In such cases, several additional treatment options to re-establish cerebral perfusion are available, including superficial temporal artery to middle cerebral artery bypass. However, it is recommended that invasive procedures should be avoided soon after IVtPA administration because tPA is believed to exert prolonged fibrinolytic effects may continue for more than 24 hours. We described three cases of emergency superficial temporal artery to middle cerebral artery bypass performed within 24 hours of IVtPA administration, and discussed the safety of such procedures. We believe that superficial temporal artery to middle cerebral artery bypass can be safely performed even within 24 hours after IVtPA administration.
authors.affiliation: National Defense Medical College, Department of Neurosurgery, Saitama, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Kojiro
authors.initials: K
authors.lastname: Wada
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Arimoto
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kumagai
authors.forename: Hideo
authors.initials: H
authors.lastname: Osada
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D013700:Giant Cell Arteritis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D010291:Paresis / Q000209:etiology / Q000628:therapy; D020521:Stroke / Q000188:drug therapy* / Q000601:surgery; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator