Matsuzono Kosuke, Suzuki Masayuki, Arai Naoto, Kim Younhee, Ozawa Tadashi, Mashiko Takafumi, Shimazaki Haruo, Koide Reiji, Fujimoto Shigeru
Division of Neurology, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Division of Neurology, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
J Stroke Cerebrovasc Dis. 2018 Jul;27(7):e132-e134. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.023. Epub 2018 Mar 7.
Some stroke patients with the acute aortic dissection receiving thrombolysis treatment resulted in fatalities. Thus, the concurrent acute aortic dissection is the contraindication for the intravenous recombinant tissue-type plasminogen activator. However, the safety and the effectiveness of the intravenous recombinant tissue-type plasminogen activator therapy are not known in patients with stroke some days after acute aortic dissection treatment. Here, we first report a case of a man with a cardioembolism due to the nonvalvular atrial fibrillation, who received the intravenous recombinant tissue-type plasminogen activator therapy 117 days after the traumatic Stanford type A acute aortic dissection operation. Without the intravenous recombinant tissue-type plasminogen activator therapy, the prognosis was expected to be miserable. However, the outcome was good with no complication owing to the intravenous recombinant tissue-type plasminogen activator therapy. Our case suggests the effectiveness and the safety of the intravenous recombinant tissue-type plasminogen activator therapy to the ischemic stroke some days after acute aortic dissection treatment.
一些患有急性主动脉夹层的中风患者接受溶栓治疗后死亡。因此，并发急性主动脉夹层是静脉注射重组组织型纤溶酶原激活剂的禁忌证。然而，急性主动脉夹层治疗数天后中风患者接受静脉注射重组组织型纤溶酶原激活剂治疗的安全性和有效性尚不清楚。在此，我们首次报告一例因非瓣膜性心房颤动导致心源性栓塞的男性患者，他在创伤性斯坦福A型急性主动脉夹层手术后117天接受了静脉注射重组组织型纤溶酶原激活剂治疗。若不进行静脉注射重组组织型纤溶酶原激活剂治疗，预后预计很差。然而，静脉注射重组组织型纤溶酶原激活剂治疗的结果良好，未出现并发症。我们的病例表明，急性主动脉夹层治疗数天后发生缺血性中风的患者接受静脉注射重组组织型纤溶酶原激活剂治疗是有效且安全的。
