title: First case of ischemic stroke which happened during continuous intravenous infusion of rt-PA.
abstract: Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus. Ischemic stroke which happened during intra-arterial thrombolysis with rt-PA has never been mentioned in literature yet and the case stands for the statement that very effective causative treatment of ischemic stroke with rt-PA is not sufficient to "prevent" ischemic stroke if used in very small doses.
authors.affiliation: Barlicki Memorial Hospital, 22 Kopcinskiego Street, 90-153 Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Zurawska
authors.affiliation: Department of Surgery, Medical University of Lodz, 22 Kopcinskiego Street, 90-153 Lodz, Poland.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Czeczotka
authors.affiliation: Department of Neurology, Stroke and Neurorehabilitation, Medical University of Lodz, 22 Kopcinskiego Street, 90-153 Lodz, Poland. Electronic address: jjrozniecki@afazja.am.lodz.pl.
authors.forename: Jacek J
authors.initials: JJ
authors.lastname: Rozniecki
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis; D002544:Cerebral Infarction / Q000188:drug therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D013923:Thromboembolism / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: Atrial fibrillation; Limb ischemia; Recombinant tissue plasminogen activator; Stroke; Thrombolysis