• BMJ case reports · Sep 2016

    Case Reports

    Orolingual angioedema to alteplase. Identify, counsel and monitor at risk patients.

    • Christopher Timmis, Elliot Epstein, and Mohmad Salim.
    • Department of Anaesthetics, Walsall Manor Hospital, Walsall, UK.
    • BMJ Case Rep. 2016 Sep 2; 2016.

    AbstractOrolingual angioedema (OLA) is a known complication of intravenous alteplase used to treat ischaemic stroke. The incidence may be as high as 5.1%. ACE inhibitors are thought to increase the risk of developing this potentially life-threatening complication. This case report demonstrates how we may improve in the identification of risk factors in the history; the counselling of patients appropriately; in seeking alternative therapies such as mechanical thrombectomy; and in the monitoring of patients for signs of OLA once alteplase has been given. 2016 BMJ Publishing Group Ltd.

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