Patient with repeated cerebral vascular occlusion receive three thrombolysis and two endovascular treatments within 103 hours: a case report

Abstract

Restoring blood flow through intravenous thrombolysis (IVT) or endovascular treatment (EVT) is the most effective therapy for acute ischemic stroke (AIS). However, reocclusion remains a common complication in patients who achieve successful revascularization. Currently, there is no recommendation for the treatment of reocclusion in the guidelines for stroke. Antiplatelet and anticoagulant drugs, repeated IVT (rIVT) and repeated EVT (rEVT) can be considered. We present a case of an AIS patient who underwent three IVTs and two EVTs. A 59-year-old man with AIS manifesting as recurrent reocclusion of the left internal carotid artery received three IVTs and two EVTs within 103 h and eventually achieved a good outcome. During the treatment, tirofiban and heparin were administrated for antithrombotic therapy. rIVT and rEVT may be viable for patients with early recurrent reocclusion after a full evaluation. This case report highlights the potential efficacy and safety of multiple revascularization therapy in a short period.