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Thrombolytic therapy for delayed, in-hospital stroke after cardiac surgery

Ikuo Fukuda1, Tomohiro Imazuru, Motoo Osaka

  • 1Department of Surgery I, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. ikuofuku@cc.hirosaki-u.ac.jp

The Annals of Thoracic Surgery
|October 8, 2003
PubMed

Insights

Intraarterial fibrinolysis effectively treated delayed stroke after cardiac surgery, achieving artery recanalization and good functional recovery in all five patients. This intervention shows promise for improving outcomes in postcardiotomy cerebral thromboembolism.

Area of Science:

  • Neurology
  • Cardiology
  • Interventional Radiology

Background:

  • Delayed stroke is a serious complication following cardiac surgery.
  • Cerebral thromboembolism can lead to significant neurological deficits.

Observation:

  • Five patients experiencing delayed stroke post-cardiac surgery were treated with intraarterial fibrinolysis.
  • The treatment targeted cerebral artery thromboembolism (n=4) or thrombosis (n=1).

Findings:

  • Complete recanalization was achieved in 3 patients, with partial recanalization in 2.
  • One patient also underwent angioplasty for basilar artery stenosis.
  • No instances of rebleeding or wound bleeding were reported.

Implications:

  • Intraarterial fibrinolysis appears safe and effective for postcardiotomy cerebral thromboembolism.
  • Prompt cerebral angiography and local thrombolysis may enhance functional recovery and survival rates.
  • This approach offers a potential therapeutic strategy for a critical post-surgical complication.

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