Thrombolysis in Patients With Acute Stroke Caused by Cervical Artery Dissection

Abstract

Background: Results of recently published studies suggest that intravenous thrombolysis (IVT) and local intraarterial thrombolysis (LIT) are feasible procedures in acute stroke after cervical artery dissection (CAD).

Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

“…Since our study was not a randomized controlled trial or case-control study no assumptions can be made about the effectiveness of rtPA treatment in this group of patients. However, our results are in line with data from previous studies that rtPA is safe and feasible in this group of patients [1][2][3][4]6]. In patients with a tandem occlusion of the internal carotid and middle cerebral artery rtPA alone might be not feasible.…”

Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

“…Since our study was not a randomized controlled trial or case-control study no assumptions can be made about the effectiveness of rtPA treatment in this group of patients. However, our results are in line with data from previous studies that rtPA is safe and feasible in this group of patients [1][2][3][4]6]. In patients with a tandem occlusion of the internal carotid and middle cerebral artery rtPA alone might be not feasible.…”

Thrombolysis in Cervical Artery Dissection – Data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome – that is, mRS 0–2 after 3 months – which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta‐analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, this rate is similar to those reported in RCTs [1,2] or the SITS‐ISTR registry [14] of IV thrombolysis for the stroke of miscellaneous causes.…”

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome -that is, mRS 0-2 after 3 months -which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta-analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, Odds for a modified Rankin Scale 0-2 at 3 months in CeAD Stroke patients treated with compared to those treated without thrombolysis adjusted for stroke severity and the presence of vessel occlusion.…”

Cervical artery dissection?clinical features, risk factors, therapy and outcome in 126 patients

“…s Treatment As in our series, results of recently published studies suggest that thrombolysis is feasible in patients with stroke due to cervical artery dissection [1, 2, 11, 30, 32, 33].As summarised by Arnold et al [2], in none of 30 patients receiving IAT or IVT complications due to extension of wall hematoma were noted. To prevent thromboembolic complications, anticoagulation with intravenous heparin followed by warfarin is usually recommended [35,36,37,39].…”

Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

“…Since our study was not a randomized controlled trial or case-control study no assumptions can be made about the effectiveness of rtPA treatment in this group of patients. However, our results are in line with data from previous studies that rtPA is safe and feasible in this group of patients [1][2][3][4]6]. In patients with a tandem occlusion of the internal carotid and middle cerebral artery rtPA alone might be not feasible.…”

Thrombolysis in Cervical Artery Dissection – Data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome – that is, mRS 0–2 after 3 months – which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta‐analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, this rate is similar to those reported in RCTs [1,2] or the SITS‐ISTR registry [14] of IV thrombolysis for the stroke of miscellaneous causes.…”

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome -that is, mRS 0-2 after 3 months -which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta-analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, Odds for a modified Rankin Scale 0-2 at 3 months in CeAD Stroke patients treated with compared to those treated without thrombolysis adjusted for stroke severity and the presence of vessel occlusion.…”

Cervical artery dissection?clinical features, risk factors, therapy and outcome in 126 patients

“…s Treatment As in our series, results of recently published studies suggest that thrombolysis is feasible in patients with stroke due to cervical artery dissection [1, 2, 11, 30, 32, 33].As summarised by Arnold et al [2], in none of 30 patients receiving IAT or IVT complications due to extension of wall hematoma were noted. To prevent thromboembolic complications, anticoagulation with intravenous heparin followed by warfarin is usually recommended [35,36,37,39].…”

Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

“…Since our study was not a randomized controlled trial or case-control study no assumptions can be made about the effectiveness of rtPA treatment in this group of patients. However, our results are in line with data from previous studies that rtPA is safe and feasible in this group of patients [1][2][3][4]6]. In patients with a tandem occlusion of the internal carotid and middle cerebral artery rtPA alone might be not feasible.…”

Thrombolysis in Cervical Artery Dissection – Data from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) database

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome – that is, mRS 0–2 after 3 months – which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta‐analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, this rate is similar to those reported in RCTs [1,2] or the SITS‐ISTR registry [14] of IV thrombolysis for the stroke of miscellaneous causes.…”

“…More than half of the thrombolyzed CeAD Stroke patients did have a favourable outcome -that is, mRS 0-2 after 3 months -which is similar to results obtained in smaller series (3/6 [6], 4/11 [5], 3/7 [7] and 17/33 [4]) and a meta-analysis across retrospective case series and case reports (55.6%) published recently [9]. Furthermore, Odds for a modified Rankin Scale 0-2 at 3 months in CeAD Stroke patients treated with compared to those treated without thrombolysis adjusted for stroke severity and the presence of vessel occlusion.…”

Cervical artery dissection?clinical features, risk factors, therapy and outcome in 126 patients

“…s Treatment As in our series, results of recently published studies suggest that thrombolysis is feasible in patients with stroke due to cervical artery dissection [1, 2, 11, 30, 32, 33].As summarised by Arnold et al [2], in none of 30 patients receiving IAT or IVT complications due to extension of wall hematoma were noted. To prevent thromboembolic complications, anticoagulation with intravenous heparin followed by warfarin is usually recommended [35,36,37,39].…”