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Partial Recanalization of a Large Vessel Acute Ischemic Stroke With Intravenous Tissue Plasminogen Activator, Followed by Systemic Anticoagulation, in the Setting of COVID-19-Induced Hypercoagulability: A Case Report.
LaBarbera, Vincent A; Azher, Aidan; Jayaraman, Mahesh V; Wendell, Linda C; Sacchetti, Daniel C; Thompson, Bradford.
  • LaBarbera VA; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Azher A; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Jayaraman MV; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Wendell LC; Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Sacchetti DC; Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Thompson B; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Neurohospitalist ; 11(3): 246-250, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-967610
ABSTRACT
We report on the use of systemic heparinization following thrombolysis with intravenous tissue plasminogen activator (t-PA) for acute ischemic large vessel stroke, in the setting of COVID-19-induced hypercoagulability, with partial recanalization of the internal carotid artery. Off-label systemic heparinization was used within 12 hours of t-PA administration, after extensive multidisciplinary collaboration and family discussion, given evidence of severe hypercoagulability. We conclude that thrombolysis should be considered for all eligible patients with suspected or confirmed COVID-19 and acute ischemic stroke, and systemic anticoagulation, although with inherent risks, may be a useful adjunct treatment modality in selected patients who have received intravenous thrombolysis.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report Language: English Journal: Neurohospitalist Year: 2021 Document Type: Article Affiliation country: 1941874420977308

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report Language: English Journal: Neurohospitalist Year: 2021 Document Type: Article Affiliation country: 1941874420977308