Thrombolysis in Ischemic Stroke Patients with Isolate Pulmonary Arteriovenous Malformations
Pulmonary arteriovenous malformations are rare cause for ischemic stroke. British Thoracic Society Clinical Statement considered insufficient evidence of safety or clinical benefit to recommend thrombolysis for stroke with pulmonary arteriovenous malformations. For pulmonary arteriovenous malformations with hereditary hemorrhagic telangiectasia, bleeding risk after thrombolysis is high, while for isolate pulmonary arteriovenous malformations, bleeding risk is much lower. We here present 2 cases of ischemic stroke with isolate pulmonary arteriovenous malformations treated with thrombolysis. Right-to-left shunt was found by contrast-enhanced transcranial Doppler in these 2 patients and pulmonary arteriovenous malformations were confirmed by contrast-transthoracic echocardiography and thoracic computed tomography angiography. Neurological signs improved after intravenous thrombolysis without bleeding complication.