Acute revascularization therapy in pregnant patients

Abstract

Ischemic stroke is uncommon during pregnancy, but decision making for acute revascularization therapy including intravenous recombinant tissue plasminogen activator (rt-PA) is difficult. The use of rt-PA remains controversial, but a systematic review of 16 patients (mean age 31.7 years) showed good results for both maternal (77.8%) and fetal (56.3%) outcomes. Pregnancy alone is not a solid contraindication for acute revascularization therapy including rt-PA. An endovascular approach might be beneficial for reducing the hemorrhagic complication; however, the treatment strategy should be considered based on the available treatment facility. Close cooperation with obstetrics is essential for the successful management of saving the lives of both the mother and the fetus.