Spontaneous spinal epidural haematoma following intra-arterial catheter-directed thrombolysis: A case report. (February 2020)

• Record Type: Journal Article
• Authors: Shannon, Nicholas Brian; Kumar, Pradesh; Tay, Kiang Hiong; Tan, Sia Yang; Chng, Siew Ping; Tay, Hsien Tsung
• Is Part Of: SAGE open medical case reports. Volume 8(2020)
• Publication Date: 2020-02
• Subjects: Acute limb ischaemia -- anticoagulation -- bleeding -- femoral artery -- iatrogenic injury -- paraplegia -- peripheral aneurysm -- rheolytic thrombectomy -- thrombolysis; Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1177/2050313X20906741
• Languages: English
• ISSNs: 2050-313X

Abstract

A 79-year-old Chinese gentleman presented with unilateral acute lower limb ischaemia and received intra-arterial catheter-directed thrombolysis, initially with good result and reversal of the ischaemia. However, he developed an extensive spontaneous spinal epidural haematoma within hours of the procedure and was left with permanent paraplegia after being deemed unsuitable for decompressive spinal surgery. This report serves as a reminder of the risk of severe complications of catheter-directed thrombolysis by describing this rare but devastating side-effect that occurred even despite early detection from onset of symptoms.