Mohamed Shirazy
Internal Medicine department, King Hamad University Hospital
Title: : A Case of Oropharyngeal Angioedema Following Intravenous Recombinant Tissue Plasminogen Activator (rtâ€PA) and Mechanical Thrombectomy
Biography
Biography: Mohamed Shirazy
Abstract
A 72-year-old housewife presented with ischemic cerebrovascular stroke. Intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) followed by mechanical thrombectomy under general anesthesia were attempted. The patient developed stridor and tongue swelling, in addition to hypotension and bradycardia, 60 min after completion of the rt-PA infusion. The airway was intubated, and intramuscular adrenaline, together with intravenous hydrocortisone and diphenhy- dramine, were administered. On the second day, the tongue edema subsided, and the cuff leak test was negative. However, extubation was not attempted due to the development of brain edema. A tracheostomy was later performed, and the patient was weaned off mechanical ventilation.