Related Experiment Video
Updated: Jun 25, 2026

The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection
M D I Vergouwen1, P A C A Beentjes, P J Nederkoorn
1Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. m.d.vergouwen@amc.uva.n
Background And Purpose:
No data of randomized controlled trials investigating the effect of thrombolysis in patients with ischemic stroke caused by an extracranial dissection are available. Previous case series suggested that thrombolysis in this group of patients is safe and improves outcome, however publication bias may play a role. The purpose of the present study was to describe outcome of consecutive patients with ischemic stroke caused by an extracranial dissection treated with recombinant tissue plasminogen activator (rtPA), derived from a well-defined ischemic stroke cohort.
Methods:
All consecutive patients with a transient ischemic attack (TIA) or ischemic stroke admitted to the Academic Medical Center Amsterdam between January 1, 2007 and September 1, 2007 were prospectively registered. Cause of TIA/stroke, treatment, and 6-months outcome were recorded.
Results:
During the study period 252 patients were evaluated with TIA or ischemic stroke. Eight patients (3%) had an extracranial dissection. Of the six rtPA treated patients, five had good clinical outcome and one patient died. The two patients who were not treated with rtPA, because of minor stroke, had good clinical outcome 6 months after index event.
Discussion:
Treatment with rtPA seems to be safe and feasible in ischemic stroke patients with an extracranial dissection.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Clot Retraction and Fibrinolysis
Ischemic Stroke ll: Pathophysiology
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...

