一名65歲男性，有慢性腎衰竭病史並長期接受血液透析治療，此次因左前臂人工洗腎透析管路阻塞而來本院行經皮冠狀動脈血管成型術治療。在行血管成形術時，病患突然發生意識喪失且單側瞳孔擴張，經緊急會診神經內科醫師評估並安排腦部電腦斷層懷疑為急性缺血性腦中風，並從病患臨床表現及當時正接受侵入性醫療行為等情況，高度懷疑為依附於人工洗腎透析管路內之血栓逆流而造成之基底動脈阻塞。該病患經心臟內科施行經動脈內注射血栓溶解劑(recombinant tissue plasminogen activator (rt-PA)) 後，病患隨即回復意識及神經學部分功能，但日後追蹤病患仍存有言語表達模糊不清等後遺症存在。

We reported the case of a 65-year-old man with chronic renal failure. After percutaneous transluminal angioplasty for an occluded arteriovenous graft, acute loss of consciousness occurred suddenly. Emergent neurological consultation resulted in activation of an acute stroke protocol. Intra-arterial thrombolysis with recombinant tissue plasminogen activator was performed, resulting in recanalization. Echocardiography, carotid Doppler sonography, and vascular intervention excluded other possible etiologies. Retrograde thromboemboli in the occluded arteriovenous graft was highly suspected.