Mai Duy Ton, DaoViet Phuong, Nguyen Tien Dung, Nguyen Quang-Anh, Nguyen Tat Thien, Hoang Viet Anh, Le Hong Trung, Nguyen Van Huy, Anh Nguyen Dat, Nguyen Van Chi, Thai Lien Nguyen Vu, Nga Vu Thi, Chu Dinh-Toi
Emergency Department, Bach Mai Hospital, Hanoi, Vietnam.
Radiology Center, Bach Mai Hospital, Hanoi, Vietnam.
J Int Med Res. 2019 Sep;47(9):4551-4556. doi: 10.1177/0300060519865626. Epub 2019 Aug 15.
The complication of myocardial infarction after using intravenous recombinant tissue plasminogen activator (rt-PA) in patients with acute ischemic stroke is rare. Several of these cases have been reported in the first 3 hours after infusion of rt-PA. There is controversy on how to manage treatment of the coronary artery, such as intravenous anticoagulants and antiplatelets, at the same time. We introduce a new strategy for treatment of a patient who had ischemic stroke and developed myocardial infarction after intravenous rt-PA therapy. Our case had coronary and cerebral intervention in combination with low-dose intravenous rt-PA. He was successfully treated for coronary occlusion with aspiration thrombectomy.
急性缺血性卒中患者静脉注射重组组织型纤溶酶原激活剂(rt-PA)后发生心肌梗死的并发症较为罕见。其中几例病例已在输注rt-PA后的最初3小时内被报道。对于如何同时处理冠状动脉的治疗,如静脉抗凝和抗血小板治疗,存在争议。我们介绍一种治疗策略,用于一名在静脉注射rt-PA治疗后发生缺血性卒中和心肌梗死的患者。我们的病例采用冠状动脉和脑血管介入联合小剂量静脉rt-PA治疗。他通过血栓抽吸术成功治疗了冠状动脉闭塞。