Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture

• DOI: 10.1007/s11239-020-02067-x
• Publication Date: 2020-02-20T17:02:51Z
• Authors: Fabrizio Sallustio; Domenico Samà; Alfredo Paolo Mas...; Federico Marrama; Mauro Fresilli; Marina Diomedi
• Keywords: Male; Plaque, Atherosclerotic; 3. Good health; Settore MED/26 - NEUROLOGIA; 03 medical and health sciences; Carotid Arteries; 0302 clinical medicine; Humans; Administration, Intravenous; Thrombolytic Therapy; Aged; Ischemic Stroke

First-line therapy of acute ischemic stroke is intravenous thrombolysis (IVT) irrespective of etiology. We report on a patient with acute ischemic stroke secondary to carotid plaque rupture who experienced plaque thrombosis and marked clinical worsening despite IVT. While the latter is the gold standard therapy optimal platelets inhibition should be guaranteed to allow a safe as possible carotid intervention. Hereby we discuss all available strategies to be considered in order to better individualized treatment decision-making.