Turkish Neurosurgery 2015 , Vol 25 , Num 4
Emergency Superficial Temporal Artery to Middle Cerebral Artery Bypass After Intravenous Administration of Tissue Plasminogen Activator for Stroke
Satoru TAKEUCHI1, Kojiro WADA1, Hirohiko ARIMOTO2, Kosuke KUMAGAI1, Hideo OSADA1, Naoki OTANI1, Kentaro MORI1
1National Defense Medical College, Department of Neurosurgery, Saitama, Japan
2Japan Defense Forces Central Hospital, Department of Neurosurgery, Tokyo, Japan
DOI : 10.5137/1019-5149.JTN.8648-13.1 Intravenous tissue plasminogen activator (IVtPA) is effective for the treatment of acute stroke. Although IVtPA is easily administered and is effective in many cases, the clinical condition of some patients can worsen after the initiation of thrombolytic therapy due to sustained cerebrovascular insufficiency. In such cases, several additional treatment options to re-establish cerebral perfusion are available, including superficial temporal artery to middle cerebral artery bypass. However, it is recommended that invasive procedures should be avoided soon after IVtPA administration because tPA is believed to exert prolonged fibrinolytic effects may continue for more than 24 hours. We described three cases of emergency superficial temporal artery to middle cerebral artery bypass performed within 24 hours of IVtPA administration, and discussed the safety of such procedures. We believe that superficial temporal artery to middle cerebral artery bypass can be safely performed even within 24 hours after IVtPA administration. Keywords : Emergency, Extra-intracranial bypass, Stroke, Tissue plasminogen activator
Corresponding author : Satoru Takeuchř, s.takeuchi@room.ocn.ne.jp