کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
1914690 1535165 2010 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Intra-arterial thrombolytic therapy for acute intracranial large artery occlusive disease in patients selected by magnetic resonance image
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی سالمندی
پیش نمایش صفحه اول مقاله
Intra-arterial thrombolytic therapy for acute intracranial large artery occlusive disease in patients selected by magnetic resonance image
چکیده انگلیسی

Background and purposeWe reported an experience of intra-arterial thrombolysis (IAT) study triaged by emergent MRI.MethodsPatients were recruited if vascular occlusions were identified by emergent MRA. Urokinase was infused hyperselectively within 6 h after onset to a maximum dose of 900,000 IU or recanalization achieved with mechanical thrombus disruption. Heparin infusion was discontinued after 2 hemorrhage in the first 7 patients. TIMI grade 2 and 3 recanalization was recognized as successful. Favorable outcomes were mRS 0–3 at 3 months.ResultsAmong 4225 ischemic stroke patients during the 29 months study period, 52 patients met the inclusion criteria with 49 screened by MRA and 3 screened by CT, 30 patients were enrolled and 25 were treated. Three patients (10%) were unable for the MRI examination due to time or equipment limit. There were 5 ICA, 13 MCA, and 7 VBA occlusions. Among 27 patients screened from MRA, 25 patients had the same occluded vessels and 2 patients had compatible occluded vessels confirmed by cerebral angiography. The median NIHSS was 26 and median time from symptom onset to IAT was 283 min. Successful recanalization was achieved in 68% (17/25). Intracerebral hemorrhage was recognized as symptomatic in 3 (12%) and asymptomatic in 8 (32%) at 3 months. Mortality was 32%. 36% patients had a mRS of 0–3 at 3 months. Patients with lower initial NIHSS score (20.9 vs. 28.4, P = 0.02) and MCA occlusions (69.3%, 9/13, P < 0.001) tend to have favorable outcomes.ConclusionsThough the incidence was low, IAT triage with emergent MRI appeared to be feasible. MRI screening might be incorporated in the future IAT studies. Mechanical thrombus disruption and heparin infusion in IAT might need further investigation in this area.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the Neurological Sciences - Volume 297, Issues 1–2, 15 October 2010, Pages 46–51
نویسندگان
, , , , , , ,