Intra-arterial thrombolysis in 24 consecutive patients with internal carotid artery T occlusions
| Autor: | Heinrich Mattle, Marcel Arnold, Caspar Brekenfeld, G Schroth, Matthias Sturzenegger, Krassen Nedeltchev, Frank Stepper, Thomas J. Loher, Luca Remonda |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Paper medicine.medical_specialty medicine.medical_treatment education Plasminogen Activators Modified Rankin Scale Surveys and Questionnaires medicine.artery Anterior cerebral artery Humans Infusions Intra-Arterial Medicine Thrombolytic Therapy cardiovascular diseases Carotid Artery Thrombosis Stroke health care economics and organizations Aged Urokinase business.industry Thrombolysis Middle Aged medicine.disease Urokinase-Type Plasminogen Activator Cerebral Angiography Surgery Psychiatry and Mental health Treatment Outcome Middle cerebral artery Female Neurology (clinical) Internal carotid artery business medicine.drug |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 74:739-742 |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp.74.6.739 |
| Popis: | To determine the safety, efficacy, and predictors of favourable outcome of intra-arterial thrombolysis in acute stroke attributable to internal carotid "T"occlusionThe authors analysed 24 consecutive patients with T occlusions of the internal carotid artery treated by local intra-arterial thrombolysis using urokinase.The median baseline National Institutes of Health Stroke Scale was 19. The average time from symptom onset to treatment was 237 minutes. Four patients (16.6%) had a favourable (modified Rankin Scale score (mRS/=2)) and 10 patients (41.7%) a poor outcome (mRS 3 or 4) after three months. Ten patients (41.7%) died. One symptomatic intracerebral haemorrhage (4.2%) occurred. Partial recanalisation of the intracranial internal carotid artery was achieved in 15 (63%), of the middle cerebral artery in four (17%), and of the anterior cerebral artery in eight patients (33%). Complete recanalisation never occurred. Sufficient leptomeningeal collaterals as seen on arteriography (p=0.02) and age60 years (p=0.012) were the only predictors of favourable clinical outcome.Acute stroke attributable to carotid T occlusion remains a condition with a generally poor prognosis even when intra-arterial thrombolysis is performed. Favourable outcome was seen only in patients with sufficient leptomeningeal collaterals. |
| Databáze: | OpenAIRE |
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