Preview

Clinical Medicine (Russian Journal)

Advanced search
Open Access Open Access  Restricted Access Subscription Access

Successful thrombolysis in an elderly patient with a large-scale hemispheric brain infarction

https://doi.org/10.30629/0023-2149-2024-102-8-661-664

Abstract

Currently, one of the primary methods of reperfusion in ischemic stroke is systemic thrombolytic therapy (TLT) using recombinant tissue plasminogen activators (rtPA). Despite TLT’s effectiveness demonstrated in several large multicenter randomized placebo-controlled clinical trials, the use of rtPA at standard dosages carries a high risk of hemorrhagic complications, especially in patients with certain aggravating factors. This article presents a clinical case of early thrombolysis in a patient with ischemic stroke, utilizing an individualized dosage of rtPA despite the presence of relative contraindications for reperfusion therapy.

About the Authors

N. V. Lomakin
Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia; Central Clinical Hospital with а Polyclinic of the Administrative Directorate of the President
Russian Federation

Nikita V. Lomakin — Doctor of Medical Sciences, Professor, Head of the Department of Cardiology;  Head of the Cardiology Department No. 2 (for X-ray surgical methods of treatment with intensive care units) 

Moscow



S. V. Vasichkin
Central Clinical Hospital with а Polyclinic of the Administrative Directorate of the President
Russian Federation

Sergey V. Vasichkin — Head of the Neurological Department for patients with ACE 

Moscow



E. A. Shirokov
Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia
Russian Federation

Evgeny A. Shirokov — Doctor of Medical Sciences, Professor, Professor of the Department of Cardiology

Moscow



B. Sh. Kurbanova
Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia
Russian Federation

Bike Sh. Kurbanova — clinical resident of the 2nd year of the Department of Cardiology

Moscow



References

1. Li L., Scott C.A., Rothwell P.M. Oxford Vascular Study. Trends in stroke incidence in high-income countries in the 21st century: population-based study and systematic review. Stroke. 2020; 51(5):1372–1380. DOI: 10.1161/STROKEAHA.119.028484

2. Kleindorfer D.O., Towfi ghi A., Chaturvedi S., Cockroft K.M., Gutierrez J., Lombardi-Hill D. et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364–e467. DOI: 10.1161/STR.0000000000000375.

3. Berger J.S., Jordan C.O., Lloyd-Jones D., Blumenthal R.S. Screening for cardiovascular risk in asymptomatic patients. J. Am. Coll. Cardiol. 2010;55(12):1169–1177. DOI: 10.1016/j.jacc.2009.09.066. PMID: 20298922

4. O’Sullivan J.W., Ashley E.A., Elliott P.M. Polygenic risk scores for the prediction of cardiometabolic disease. Eur. Heart J. 2023;44(2):89– 99. DOI: 10.1093/eurheartj/ehac648. PMID: 36478054

5. Ischemic stroke and transient ischemic attack in adults. Clinical recommendations. 2021. (In Russian)].

6. Toul M., Mican J., Slonkova V. Hidden potential of highly effi cient and widely accessible thrombolytic staphylokinase. Stroke. 2022;53:00–00. DOI: 10.1161/STROKEAHA.122.040219

7. Altersberger V.L., Sibolt G., Enz LS., Hametner C., Scheitz J.F., Henon H.et al. TRISP collaborators. Intravenous Thrombolysis 4.5–9 Hours After Stroke Onset: A Cohort Study from the TRISP Collaboration. Ann. Neurol. 2023;94(2):309–320. DOI: 10.1002/ana.26669. Epub 2023 May 13. PMID: 37114466.

8. Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., Blomström-Lundqvist C.et al. ESC Scientifi c Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fi brillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fi brillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur. Heart J. 2021;42(5):373–498. DOI: 10.1093/eurheartj/ehaa612


Review

For citations:


Lomakin N.V., Vasichkin S.V., Shirokov E.A., Kurbanova B.Sh. Successful thrombolysis in an elderly patient with a large-scale hemispheric brain infarction. Clinical Medicine (Russian Journal). 2024;102(8):661-664. (In Russ.) https://doi.org/10.30629/0023-2149-2024-102-8-661-664

Views: 166


ISSN 0023-2149 (Print)
ISSN 2412-1339 (Online)