{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:27:15Z","timestamp":1783114035905,"version":"3.54.6"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Orolingual angioedema (OA) represents a rare but life\u2010threatening complication among patients with acute ischemic stroke treated with intravenous thrombolysis with alteplase. Novel agents, including icatibant, are recommended in resistant patients with alteplase\u2010induced OA who have failed to respond to first\u2010line therapies including corticosteroids, antihistamines, and\/or adrenaline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We present a patient with alteplase\u2010induced OA who showed substantial clinical improvement following the administration of icatibant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We describe a 71\u2010year\u2010old woman with known arterial hypertension under treatment with angiotensin\u2010converting enzyme inhibitor, who presented with acute ischemic stroke in the territory of the right middle cerebral artery and received intravenous alteplase. During intravenous thrombolysis, the case was complicated with OA without any response to standard anaphylactic treatment including corticosteroids, dimetindene, and adrenaline. Thirty minutes after symptom onset, icatibant, a synthetic selective bradykinin B2\u2010receptor antagonist, was administered subcutaneously. Substantial symptomatic resolution was observed only following the icatibant administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case highlights the effectiveness of icatibant in the acute management of alteplase\u2010induced OA. In particular, icatibant administration, following first\u2010line therapies including corticosteroids, antihistamines, and\/or adrenaline, may avert tracheostomy and intubation in resistant and refractory cases with OA following intravenous thrombolysis for acute ischemic stroke.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16173","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T06:05:57Z","timestamp":1703829957000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Icatibant averting mechanical ventilation in acute ischemic stroke patient with alteplase\u2010induced orolingual angioedema"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-2610","authenticated-orcid":false,"given":"Aikaterini","family":"Theodorou","sequence":"first","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia\u2010Makrina","family":"Dimitriadou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Tzanetakos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Bakola","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chondrogianni","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Keramida","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Vassilopoulou","sequence":"additional","affiliation":[{"name":"First Department of Neurology, School of Medicine, Eginition Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Makris","sequence":"additional","affiliation":[{"name":"Allergy Unit \u201cD. Kalogeromitros\u201d, Second Department of Dermatology and Venereology, School of Medicine Attikon University Hospital, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios P.","family":"Paraskevas","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, Attikon University Hospital National and Kapodistrian University of Athens  Athens Greece"},{"name":"Department of Neurology University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.03.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013334"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.025260"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2016.02.019"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1312524"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906393"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.03.032"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.09.039"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.33588\/rn.6906.2019123"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-236643"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T09:37:21Z","timestamp":1710754641000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,28]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/ene.16173"],"URL":"https:\/\/doi.org\/10.1111\/ene.16173","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,28]]},"assertion":[{"value":"2023-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16173"}}