Recurrent artery-to-artery embolism during intravenous t-PA therapy for acute ischemic stroke

Christopher D. Anderson, Deborah L. Bergman, Richard A. Bernstein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Treatment of acute ischemic stroke with systemic thrombolysis in the presence of a proximal thrombo-embolic source carries a theoretical risk of thrombus fragmentation and recurrent embolization. Intracardiac thrombus has received the most attention as a potential source of recurrent emboli, and in the past, it was considered a relative contra-indication to tissue plaminogen activator (t-PA) treatment. More recent data show that recurrent embolization from a cardiac source during t-PA infusion is rare. Case Report: This article describes recurrent symptomatic basilar artery embolization during t-PA infusion from acute thrombus in the proximal cervical vertebral artery. Discussion: This case provides evidence that intravenous t-PA must be used cautiously in the presence of large proximal thrombo-embolic sources and that intraluminal thrombus in a large cervical artery should be considered one such source.

Original languageEnglish (US)
Pages (from-to)54-56
Number of pages3
JournalNeurocritical Care
Issue number1
StatePublished - Aug 2005


  • Acute ischemic stroke
  • Artery-to-artery embolism
  • Recurrent embolism
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine


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