title: Orolingual Angioedema During or After Thrombolysis for Cerebral Ischemia.
abstract: Orolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE.
  
  
  
  We prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE.
  
  
  
  Of 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6-9.7; P=0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5-16.5; P=0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6-11.9; P=0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3-8.1; P=0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3-2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1-1.8), and death (adjOR, 1.1; 95% CI, 0.3-3.8).
  
  
  
  OLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Fjorda
authors.initials: F
authors.lastname: Myslimi
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: François
authors.initials: F
authors.lastname: Caparros
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Nelly
authors.initials: N
authors.lastname: Dequatre-Ponchelle
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Solène
authors.initials: S
authors.lastname: Moulin
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Sophie
authors.initials: S
authors.lastname: Gautier
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Patrick
authors.initials: P
authors.lastname: Girardie
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
authors.forename: Régis
authors.initials: R
authors.lastname: Bordet
authors.affiliation: From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.). didier.leys@univ-lille2.fr.
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000139:chemically induced*; D000799:Angioedema / Q000139:chemically induced* / Q000453:epidemiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D002545:Brain Ischemia / Q000188:drug therapy*; D002540:Cerebral Cortex / Q000098:blood supply; D002544:Cerebral Infarction / Q000188:drug therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008047:Lip Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use; D014060:Tongue Diseases / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: angioedema; cerebral hemorrhage; ischemia; odds ratio; outcome