Recanalization of occluded large arteries with broadened therapeutic window for acute cerebral infarction

ObjectiveTo investigate the safety and efficacy of recanalization with a broadened therapeutic window for acute occlusion of large cerebral arteries.MethodsWe assessed 38 patients who underwent the hyper-selective intra-arterial administration of low-dose urokinase, along with mechanical thrombus disruption or mechanical thrombus disruption recanalization (34 stents in 33 patients) of occluded vessels, 20 with onset time-to-treatment (OTT) >6 h (observation group; mean OTT, 20.10 ± 15.67 h) and 18 with OTT ≤6 h (control group). NIHSS scores, mRS scores (≤2) at 3 months, recanalization rates, severe cerebral infarctions on CT, and symptomatic hemorrhagic conversions after surgery were compared.ResultsPostoperative recanalization rates were 100% in both groups, and other results were equivalent.ConclusionsRecanalization at longer OTT was safe and effective with acute occlusions of large cerebral arteries. Time to recanalization could be safely prolonged for up to 20 h in these patients.