{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:32:50Z","timestamp":1762835570414,"version":"build-2065373602"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute ischemic stroke (AIS) is associated with an increased risk of mortality in surgical patients and its management is a clinical challenge. We present a case of a patient with AIS and concomitant perforated peptic ulcer, and venous thrombolysis was performed. Due to persistent abdominal pain, computed tomography was performed, showing free abdominal gas, and open surgery revealed duodenal perforation, which was corrected by excision, Mikulitz pyloroplasty, and Cellan-Jones patch. Several complications were observed in the postoperative period, which were treated conservatively, without lasting consequences. At follow-up, the patient regained almost full motor function and had no complaints regarding the repaired perforation. Venous thrombolysis is an effective treatment for AIS, but no cases have been described in surgical patients. This case represents an unconventional, simultaneous approach to the treatment of both initial conditions. Both treatment methods\u2014thrombolysis and surgical procedure\u2014can be successfully applied in selected cases.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf886","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:28:39Z","timestamp":1762835319000},"source":"Crossref","is-referenced-by-count":0,"title":["Rare case of thrombolysis for ischemic stroke with a concurrent perforated duodenal ulcer"],"prefix":"10.1093","volume":"2025","author":[{"given":"Rositsa Gancheva","family":"Krasteva","sequence":"first","affiliation":[{"name":"Department of Neurology, University Multiprofile Hospital for Active Treatment MEDIKA , Ruse 7000 ,","place":["Bulgaria"]},{"name":"Department of Health Care, University of Ruse \u201cAngel Kanchev\u201d , Ruse 7000 ,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsanko I","family":"Yotsov","sequence":"additional","affiliation":[{"name":"Department of Health Care, University of Ruse \u201cAngel Kanchev\u201d , Ruse 7000 ,","place":["Bulgaria"]},{"name":"Department of Surgery, University Multiprofile Hospital for Active Treatment MEDIKA , Ruse ,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina K","family":"Stancheva","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Multiprofile Hospital for Active Treatment MEDIKA , Ruse 7000 ,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"2025111023283332000_ref1","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1016\/S0140-6736(15)00276-7","article-title":"Perforated peptic ulcer","volume":"386","author":"S\u00f8reide","year":"2015","journal-title":"Lancet"},{"key":"2025111023283332000_ref2","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1056\/NEJMoa2402980","article-title":"Tenecteplase for ischemic stroke at 4.5 to 24 hours without thrombectomy","volume":"391","author":"Xiong","year":"2024","journal-title":"N Engl J Med"},{"key":"2025111023283332000_ref3","doi-asserted-by":"publisher","first-page":"3034","DOI":"10.1161\/STROKEAHA.117.017957","article-title":"Thrombolysis in postoperative stroke","volume":"48","author":"Voelkel","year":"2017","journal-title":"Stroke"},{"key":"2025111023283332000_ref4","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.2165\/00003088-200241150-00001","article-title":"Pharmacokinetics and pharmacodynamics of tenecteplase in fibrinolytic therapy of acute myocardial infarction","volume":"41","author":"Tanswell","year":"2002","journal-title":"Clin Pharmacokinet"},{"key":"2025111023283332000_ref5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/S0140-6736(22)01054-6","article-title":"Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial","volume":"400","author":"Menon","year":"2022","journal-title":"Lancet (London, England)"},{"key":"2025111023283332000_ref6","doi-asserted-by":"publisher","first-page":"268","DOI":"10.14740\/jocmr4877","article-title":"Timing of postoperative stroke and risk of mortality after noncardiac surgery: a cohort study","volume":"15","author":"Mpody","year":"2023","journal-title":"J Clin Med Res"},{"key":"2025111023283332000_ref7","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1002\/jcph.2164","article-title":"Population pharmacokinetics of tenecteplase in patients with acute myocardial infarction and application to patients with acute ischemic stroke","volume":"63","author":"Tang","year":"2023","journal-title":"J Clin Pharmacol"},{"key":"2025111023283332000_ref8","doi-asserted-by":"publisher","first-page":"3440","DOI":"10.1161\/strokeaha.120.029749","article-title":"Tenecteplase thrombolysis for acute ischemic stroke","volume":"51","author":"Warach","year":"2020","journal-title":"Stroke"},{"key":"2025111023283332000_ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1161\/JAHA.123.031692","article-title":"Comprehensive review of tenecteplase for thrombolysis in acute ischemic stroke","volume":"13","author":"Wang","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"2025111023283332000_ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4240\/wjgs.v9.i1.1","article-title":"Perforated peptic ulcer\u2014an update","volume":"9","author":"Chung","year":"2017","journal-title":"World J Gastrointest Surg"},{"key":"2025111023283332000_ref11","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.ijsu.2016.07.077","article-title":"Laparoscopic versus open repair for perforated peptic ulcer: a meta analysis of randomized controlled trials","volume":"33","author":"Tan","year":"2016","journal-title":"Int J Surg"}],"container-title":["Journal of Surgical Case 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