کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
2707188 | 1144841 | 2011 | 6 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Carotid Duplex Ultrasonography Can Predict Outcome of Intravenous Alteplase Therapy for Hyperacute Stroke
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کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
مغز و اعصاب بالینی
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چکیده انگلیسی
We evaluated whether carotid duplex ultrasonography (US) can help predict the safety and efficacy of treating hyperacute stroke with intravenous (IV) tissue plasminogen activator (alteplase) therapy. Consecutive patients with stroke were assigned to the carotid artery occlusion (CO) group or the other (non-CO) group according to US findings before or immediately after receiving IV alteplase. Effectiveness and safety outcomes included early neurologic improvement, defined as a reduction in a National Institutes of Health Stroke Scale (NIHSS) score of â¥4 points within the initial 24 hours after stroke onset; completely independent routine activity, defined as a modified Rankin Scale score of â¤1 at day 90 after stroke onset; symptomatic intracranial hemorrhage (ICH) occurring within 36 hours after stroke onset; and any ICH. We enrolled 127 patients (27 in the CO group and 100 in the non-CO group) with a median baseline NIHSS score of 13 (range, 4-30). The CO group had a higher baseline NIHSS score (median, 18 vs 12; P = .005). After multivariate adjustment, the CO group was inversely associated with early improvement (odds ratio [OR] = 0.26; 95% confidence interval [CI] = 0.09-0.72) and independence at day 90 (OR = 0.23; 95% CI = 0.05-0.73) and positively associated with any ICH (OR = 3.11; 95% CI = 1.23-8.48). Our findings indicate that CO identified by US in the emergency clinical setting is an independent predictor of unfavorable outcome and ICH following IV alteplase therapy.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Stroke and Cerebrovascular Diseases - Volume 20, Issue 1, JanuaryâFebruary 2011, Pages 24-29
Journal: Journal of Stroke and Cerebrovascular Diseases - Volume 20, Issue 1, JanuaryâFebruary 2011, Pages 24-29
نویسندگان
Masatoshi MD, Kazunori MD, Takahiro MD, Boo-Han MD, Toshiyuki MD, Chiaki MD, Kazuyuki MD, Hiroaki MD, Kazuo MD,