View in EDS HTML Full Text PDF Full Text

Incidence of orolingual angioedema after intravenous thrombolysis for stroke.

Saved in:
Bibliographic Details
Title: Incidence of orolingual angioedema after intravenous thrombolysis for stroke.
Authors: Censori, Bruno, Partziguian, T., Bonito, V., Sgarzi, M., Riva, R., Alimonti, D., Agazzi, E., Vedovello, M., Frigeni, B., Venturelli, E., La Gioia, S., Barcella, V., Daleffe, L., Longhi, L., Ferri, F., Cosentini, R., Rottoli, M. R.
Source: Neurological Sciences. Nov2018, Vol. 39 Issue 11, p1877-1879. 3p. 1 Chart.
Subjects: Angioneurotic edema, Alteplase, Thrombolytic therapy, Disease complications, Bradykinin, ACE inhibitors, Stroke patients
Abstract: Introduction: Orolingual angioedema (OA) is a known adverse effect of intravenous (i.v.) alteplase. We analyzed all patients treated with i.v. alteplase for stroke at our hospital since approval of i.v. thrombolysis in Italy in 2004 to assess the incidence of this complication.Patients and Results: Four hundred thirty-three patients received alteplase for stroke from April 2004 to May 2017. Two women developed OA (0.4%; 95% confidence interval 0.1 to 1.6%). Angioedema was mild in one case and severe in the other, with massive swelling of the lips, tongue, and oropharyngeal mucosa, and oropharyngeal bleeding, requiring intubation. Neither patient used ACE-inhibitors.Discussion: The incidence of orolingual angioedema was very low in our series. Although OA is usually mild, anaphylactoid reactions may rarely occur, because of the variable degree of activation of the complement system and kinin cascade caused by alteplase. In such instances, admission to neurointensive care may be required. Specific bradykinin antagonists or drugs that target the kallikrein-kinin system are beginning to be used in the more severe cases. Thus, doctors and nurses caring for acute stroke patients need to be able to recognize and treat this complication. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
Description
Abstract:<bold>Introduction: </bold>Orolingual angioedema (OA) is a known adverse effect of intravenous (i.v.) alteplase. We analyzed all patients treated with i.v. alteplase for stroke at our hospital since approval of i.v. thrombolysis in Italy in 2004 to assess the incidence of this complication.<bold>Patients and Results: </bold>Four hundred thirty-three patients received alteplase for stroke from April 2004 to May 2017. Two women developed OA (0.4%; 95% confidence interval 0.1 to 1.6%). Angioedema was mild in one case and severe in the other, with massive swelling of the lips, tongue, and oropharyngeal mucosa, and oropharyngeal bleeding, requiring intubation. Neither patient used ACE-inhibitors.<bold>Discussion: </bold>The incidence of orolingual angioedema was very low in our series. Although OA is usually mild, anaphylactoid reactions may rarely occur, because of the variable degree of activation of the complement system and kinin cascade caused by alteplase. In such instances, admission to neurointensive care may be required. Specific bradykinin antagonists or drugs that target the kallikrein-kinin system are beginning to be used in the more severe cases. Thus, doctors and nurses caring for acute stroke patients need to be able to recognize and treat this complication. [ABSTRACT FROM AUTHOR]
ISSN:15901874
DOI:10.1007/s10072-018-3512-1