• Fjorda Myslimi, François Caparros, Nelly Dequatre-Ponchelle, Solène Moulin, Sophie Gautier, Patrick Girardie, Charlotte Cordonnier, Régis Bordet, and Didier Leys.
• From the Departments of Neurology (F.M., F.C., N.D.-P., S.M., C.C., D.L.), Intensive Care Medicine (P.G.), and Pharmacology (S.G., R.B.), University Lille 2, Lille, France; INSERM U 1171, Lille University Hospital (S.M., S.G., C.C., R.B., D.L.), Lille, France; and University of Medicine of Tirana, Tirana, Albania (F.M.).
• Stroke. 2016 Jul 1; 47 (7): 1825-30.

Background And PurposeOrolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE.MethodsWe prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE.ResultsOf 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6-9.7; P=0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5-16.5; P=0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6-11.9; P=0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3-8.1; P=0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3-2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1-1.8), and death (adjOR, 1.1; 95% CI, 0.3-3.8).ConclusionsOLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.© 2016 American Heart Association, Inc.

41 keywords...

hide…