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Intra-arterial thrombolysis for perioperative stroke after open heart surgery

From the Cerebrovascular Center, Departments of Neurology (Drs. Katzan, Furlan, Sila, and Andrefsky) and Radiology (Drs. Masaryk and Perl), and the Department of Cardiothoracic Surgery (Drs. Cosgrove, Sabik, and McCarthy), Cleveland Clinic Foundation, Cleveland, OH.

Address correspondence and reprint requests to Dr. Anthony J. Furlan, Cerebrovascular Center, S91, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

Recent major surgery is an exclusion criterion for thrombolysis. Six patients with acute ischemic stroke underwent intra-arterial thrombolysis after recent open heart surgery without clinically significant bleeding complications, although one patient developed a small, asymptomatic cerebellar hemorrhage. Intra-arterial thrombolysis may be an option for patients with cerebral embolism in the perioperative period.

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