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01-11-2018 | Original Article

Incidence of orolingual angioedema after intravenous thrombolysis for stroke

Authors: Bruno Censori, T. Partziguian, V. Bonito, M. Sgarzi, R. Riva, D. Alimonti, E. Agazzi, M. Vedovello, B. Frigeni, E. Venturelli, S. La Gioia, V. Barcella, L. Daleffe, L. Longhi, F. Ferri, R. Cosentini, M. R. Rottoli

Published in: Neurological Sciences | Issue 11/2018

Abstract

Introduction

Orolingual angioedema (OA) is a known adverse effect of intravenous (i.v.) alteplase. We analyzed all patients treated with i.v. alteplase for stroke at our hospital since approval of i.v. thrombolysis in Italy in 2004 to assess the incidence of this complication.

Patients and results

Four hundred thirty-three patients received alteplase for stroke from April 2004 to May 2017. Two women developed OA (0.4%; 95% confidence interval 0.1 to 1.6%). Angioedema was mild in one case and severe in the other, with massive swelling of the lips, tongue, and oropharyngeal mucosa, and oropharyngeal bleeding, requiring intubation. Neither patient used ACE-inhibitors.

Discussion

The incidence of orolingual angioedema was very low in our series. Although OA is usually mild, anaphylactoid reactions may rarely occur, because of the variable degree of activation of the complement system and kinin cascade caused by alteplase. In such instances, admission to neurointensive care may be required. Specific bradykinin antagonists or drugs that target the kallikrein-kinin system are beginning to be used in the more severe cases. Thus, doctors and nurses caring for acute stroke patients need to be able to recognize and treat this complication.

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Title: Incidence of orolingual angioedema after intravenous thrombolysis for stroke
Authors: Bruno Censori
T. Partziguian
V. Bonito
M. Sgarzi
R. Riva
D. Alimonti
E. Agazzi
M. Vedovello
B. Frigeni
E. Venturelli
S. La Gioia
V. Barcella
L. Daleffe
L. Longhi
F. Ferri
R. Cosentini
M. R. Rottoli
Publication date: 01-11-2018
Publisher: Springer Milan
Published in: Neurological Sciences / Issue 11/2018
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-018-3512-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incidence of orolingual angioedema after intravenous thrombolysis for stroke

Abstract

Introduction

Patients and results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and results

Discussion

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