Abstract Details

Title Alteplase-induced facial orolingual angioedema

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-012

Background

r-TPA induced angioedema is a common clinical finding after medication infusion for acute stroke. The incidence of this complication ranges from 1.3-8% (3, 4). Prognosis is usually good; most patients have symptom resolution within 72 hours (5).

Objective Represent post-thrombolysis angioedema, a relatively common adverse effect seen after administration of alteplase for acute ischemic stroke.

Design/Methods Literature review revealed how signs and symptoms of angioedema differ in presentation and severity. We gathered case reports from the last decade to identify the most common location of stroke, site of edema, treatment used and complications of angioedema.

Results

Symptoms usually began within 150 minutes after initial infusion (mean 70 minutes) and usually presented with unilateral angioedema, contralaterally to the side of the stroke. Approximately 30% of the patients required mechanical ventilation; most were on treatment with ACE inhibitors. The authors usually treated patients with a combination of steroids, antihistamines, adrenalin, or Icatibant, with complete recovery within 24 to 48 hours.

Conclusions Patients treated with Icatibant improved within minutes and achieved full remission in the first three hours. We believe it may become the standard of care in patients presenting with this uncommon but potentially life-threatening complication.

Authors/Disclosures
Enrique Gomez Figueroa, MD, MSc PRESENTER	Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Johnson LATAM.
Juan C. Ayala Alvarez, MD (Asunción 1687)	Dr. Ayala Alvarez has nothing to disclose.
Ivan Roque Sanchez, MD (St barbara hospital)	Dr. Roque Sanchez has nothing to disclose.
	No disclosure on file
	No disclosure on file
Jose L. Ruiz-Sandoval, MD	Dr. Ruiz-Sandoval has nothing to disclose.