Intra-arterial tissue plasminogen activator for thrombosis complicating cerebral angiography in a 17-year-old girl.

Abstract

Few reports describe the use of intraarterial recombinant tissue plasminogen activator to treat intracranial thrombosis in children. A 17-year-old girl with a history of prior venous thrombosis developed a left middle cerebral artery thrombus during diagnostic cerebral angiogram. Therapy with intra-arterial tissue plasminogen activator was initiated. An immediate follow-up angiogram demonstrated recanalization, and diffusion-weighted magnetic resonance imaging 9 hours later showed no evidence of infarction. Following the angiogram, femoral artery thrombosis developed. Treatment with supratherapeutic levels of heparin, localized delivery of intra-arterial tissue plasminogen activator, embolectomy, danaparoid, and dipyridamole failed to re-establish perfusion to the lower leg, and below the knee amputation was required. Neurologic examination remained normal 1 year later. Cerebral damage was avoided with the use of emergency intra-arterial tissue plasminogen activator for cerebral artery thrombosis in this child.

• Authors: Meredith R Golomb, Mubeen Rafay, Derek Armstrong, Patricia Massicotte, Rosalind Curtis, Selina Hune, Gabrielle A deVeber
• Journal: Journal of child neurology (J Child Neurol) Vol. 18 Issue 6 Pg. 420-3 (Jun 2003) ISSN: 0883-0738 [Print] United States
• PMID: 12886978 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator

Topics

• Adolescent
• Cerebral Angiography
• Female
• Fibrinolytic Agents (administration & dosage, therapeutic use)
• Humans
• Infarction, Middle Cerebral Artery (diagnostic imaging, drug therapy)
• Infusions, Intra-Arterial
• Tissue Plasminogen Activator (administration & dosage, therapeutic use)