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

Meredith R. Golomb, Mubeen Rafay, Derek Armstrong, Patricia Massicotte, Rosalind Curtis, Selina Hune, Gabrielle A. deVeber

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Few reports describe the use of intra-arterial 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.

Original languageEnglish (US)
Pages (from-to)420-423
Number of pages4
JournalJournal of child neurology
Volume18
Issue number6
DOIs
StatePublished - Jun 1 2003

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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