Utilization of a Supraglottic Airway Device for Airway Rescue and Tamponade of an Oropharyngeal Hemorrhage After Systemic Thrombolysis for an Acute Ischemic Stroke: A Case Report

A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask v...

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Bibliographic Details
Published inA&A practice Vol. 18; no. 4; p. e01782
Main Authors Hashim, Salman, Patel, Nishita, Nozari, Ala, Mustafa, Wissam
Format Journal Article
LanguageEnglish
Published United States 01.04.2024
Subjects
Adult
Hemorrhage
Humans
Ischemic Stroke
Male
Thrombolytic Therapy
Tissue Plasminogen Activator - therapeutic use
Trachea
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Summary:A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask ventilation with an oral airway proved difficult. The team successfully placed a supraglottic airway (SGA) through which an oral endotracheal tube (ETT) was advanced over a fiberoptic bronchoscope into the trachea. The SGA remained overnight with the cuff inflated to tamponade the bleeding. The ETT was exchanged over an airway exchange catheter on postoperative day 1 without further airway complications.
ISSN:2575-3126
DOI:10.1213/XAA.0000000000001782