A Case of Oropharyngeal Angioedema Following Intravenous Recombinant Tissue Plasminogen Activator (rt-PA) and Mechanical Thrombectomy

A 72-year-old housewife presented with ischemic cerebrovascular stroke. Intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) followed by mechanical thrombectomy under general anesthesia were attempted. The patient developed stridor and tongue swelling, in addition to hypot...

Full description

Saved in:
Bibliographic Details
Published inDrug safety - case reports Vol. 6; no. 1; pp. 1 - 3
Main Authors Shirazy, Mohamed, Chaari, Anis, Hakim, Karim, Bousselmi, Kamel, Kauts, Vipin
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.12.2019
Springer Nature B.V
Subjects
Airway management
Angioedema
Bats
Case Report
Case reports
Drug Safety and Pharmacovigilance
Edema
Inflammation
Medicine
Medicine & Public Health
Ostomy
Pharmacology/Toxicology
Side effects
Stroke
Thrombolytic drugs
Online AccessGet full text

Cover

More Information
Summary:A 72-year-old housewife presented with ischemic cerebrovascular stroke. Intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) followed by mechanical thrombectomy under general anesthesia were attempted. The patient developed stridor and tongue swelling, in addition to hypotension and bradycardia, 60 min after completion of the rt-PA infusion. The airway was intubated, and intramuscular adrenaline, together with intravenous hydrocortisone and diphenhydramine, were administered. On the second day, the tongue edema subsided, and the cuff leak test was negative. However, extubation was not attempted due to the development of brain edema. A tracheostomy was later performed, and the patient was weaned off mechanical ventilation.
ISSN:2199-1162
2198-977X
DOI:10.1007/s40800-019-0104-9