Coronary Angiography Complicated by Acute Ischaemic Stroke and the Use of Thrombolysis: a Cardiology Perspective and Narrative Review of Current Literature.
Julian H GinJulian YeohVincent ThijsDavid ClarkJan Kee HoMark HorriganOmar FarouqueAli Al-FiadhPublished in: Current cardiology reports (2023)
The pathophysiology for CAAIS may be different from acute ischaemic stroke in the general population. Embolic phenomena from dislodgement of calcium or other debris during manipulation of instrumentation during CA or PCI are likely mechanisms. This may contribute to altered thrombus composition, which affects the efficacy of IVT as suggested in recent studies. Furthermore, IVT in the management of CAAIS has not been evaluated specifically. The utilization of IVT should be carefully considered in CAAIS given a paucity of evidence demonstrating safety and efficacy in this setting. A multidisciplinary pathway that emphasizes the involvement of cardiologists in the treatment decision-making process would aid in thoughtful risk-benefit evaluation for IVT use in CAAIS and reduce adverse patient outcomes. Future studies to assess the impact of this pathway on CAAIS outcomes would be beneficial.
Keyphrases
- liver failure
- decision making
- respiratory failure
- drug induced
- aortic dissection
- systematic review
- case control
- coronary artery disease
- pulmonary embolism
- acute coronary syndrome
- acute myocardial infarction
- hepatitis b virus
- percutaneous coronary intervention
- type diabetes
- emergency department
- cardiac surgery
- atrial fibrillation
- antiplatelet therapy
- quality improvement
- combination therapy
- st elevation myocardial infarction
- extracorporeal membrane oxygenation
- smoking cessation
- glycemic control
- thoracic surgery