Thrombolytics May Be Safe in People With Unruptured Brain Aneurysms

A clinical trial published in Neurology found that thrombolytics, colloquially known as clot-busters, may be safe in people with unruptured brain aneurysms. Record review of 3,953 individuals who had an ischemic stroke and were treated with thrombolytics showed aneurysm rupture occurred in only 2.3%. 

A total of 132 individuals whose records were reviewed had 1 or more unruptured saccular (n=141) or fusiform (n=14) aneurysms. In the 3 individuals who had aneurysm rupture followed by hemorrhagic stroke, all were fusiform basilar artery aneurysms. All 3 of these individuals were treated with blood thinners as well as thrombolytics.

“Our results suggest that thrombolytic therapy may be relatively safe for people with ischemic stroke even if they have larger saccular aneurysms that have not ruptured,” said Jyri Juhani Virta, MD, PhD, University of Helsinki. “For people with large fusiform aneurysms, additional consideration should be taken regarding treatment as blood thinners may increase the risk of aneurysm rupture.”

For the study, researchers examined the records of participants who were treated for a stroke with clot-busting drugs at a stroke center in Finland over 15 years. After determining how many had unruptured aneurysms, the researchers found the number of participants who had a hemorrhagic stroke caused by the rupture of the aneurysm while in the hospital after the treatment.