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Thrombolysis Following Central Venous Catheter Placement. 2020

Kenichi Sakuta, and Ryoji Nakada, and Shinji Miyagawa, and Izumu Hasegawa, and Hiroshi Yaguchi
Department of Neurology, Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-8567 Chiba, Japan. Electronic address: kenichisakuta@jikei.ac.jp.

Thrombolytic agents are infusion formulations, and some patients cannot be cannulated by a peripheral venous route. This report describes a patient with acute ischemic stroke who was administered alteplase following central venous catheter placement. An 82-year-old man with paroxysmal atrial fibrillation presented with left unilateral spatial neglect and left hemiparesis. Magnetic resonance imaging showed acute cerebral infarction located in the right cerebrum without occlusion of the main artery. The infarction was considered appropriately indicated for thrombolysis. However, no peripheral venous access could be secured, even by trained emergency room physicians. A central venous catheter was therefore placed in the right jugular vein and thrombolysis was performed. After treatment, neurological deficits completely resolved without any clinically serious bleeding. Venous catheter placement may be a safe alternative to peripheral vein access in such a circumstance.

UI MeSH Term Description Entries
D007601 Jugular Veins Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins. Jugular Vein,Vein, Jugular,Veins, Jugular
D008297 Male Males
D010959 Tissue Plasminogen Activator A proteolytic enzyme in the serine protease family found in many tissues which converts PLASMINOGEN to FIBRINOLYSIN. It has fibrin-binding activity and is immunologically different from UROKINASE-TYPE PLASMINOGEN ACTIVATOR. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. Alteplase,Plasminogen Activator, Tissue-Type,T-Plasminogen Activator,Tissue-Type Plasminogen Activator,Actilyse,Activase,Lysatec rt-PA,TTPA,Tisokinase,Tissue Activator D-44,Lysatec rt PA,Lysatec rtPA,Plasminogen Activator, Tissue,Plasminogen Activator, Tissue Type,T Plasminogen Activator,Tissue Activator D 44,Tissue Type Plasminogen Activator
D002405 Catheterization, Central Venous Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein. Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D005343 Fibrinolytic Agents Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN. Antithrombic Drug,Antithrombotic Agent,Antithrombotic Agents,Fibrinolytic Agent,Fibrinolytic Drug,Thrombolytic Agent,Thrombolytic Agents,Thrombolytic Drug,Antithrombic Drugs,Fibrinolytic Drugs,Thrombolytic Drugs,Agent, Antithrombotic,Agent, Fibrinolytic,Agent, Thrombolytic,Agents, Antithrombotic,Drug, Antithrombic,Drug, Fibrinolytic,Drug, Thrombolytic,Drugs, Antithrombic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D015912 Thrombolytic Therapy Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts. Fibrinolytic Therapy,Thrombolysis, Therapeutic,Therapeutic Thrombolysis,Therapy, Fibrinolytic,Therapy, Thrombolytic,Fibrinolytic Therapies,Therapeutic Thrombolyses,Therapies, Fibrinolytic,Therapies, Thrombolytic,Thrombolyses, Therapeutic,Thrombolytic Therapies
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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