RT Journal Article
SR Electronic
T1 Recanalization after thrombolysis in stroke patients
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 39
OP 44
DO 10.1212/01.wnl.0000250341.38014.d2
VO 68
IS 1
A1 Zangerle, A.
A1 Kiechl, S.
A1 Spiegel, M.
A1 Furtner, M.
A1 Knoflach, M.
A1 Werner, P.
A1 Mair, A.
A1 Wille, G.
A1 Schmidauer, C.
A1 Gautsch, K.
A1 Gotwald, T.
A1 Felber, S.
A1 Poewe, W.
A1 Willeit, J.
YR 2007
UL http://n.neurology.org/content/68/1/39.abstract
AB Objective: To estimate rates, predictors, and prognostic importance of recanalization in an unselected series of patients with stroke treated with IV thrombolysis. Methods: We performed a CT angiography or transcranial Doppler (TCD) follow-up examination 24 hours after IV thrombolysis in 64 patients with documented occlusion of the intracranial internal carotid or middle cerebral artery (MCA). Complete recanalization was defined by a rating of 3 on the Thrombolysis in Myocardial Infarction or 4/5 on the Thrombolysis in Brain Ischemia grading scales. Information about risk factors, clinical features, and outcome was prospectively collected by standardized procedures. Results: Complete recanalization was achieved in 36 of the 64 patients (56.3%). There was a nonsignificant trend of recanalization rates to decline with a more proximal site of occlusion: 68.4% (M2 segment of MCA), 53.1% (M1 segment), and 46.2% (carotid T) (p for trend = 0.28). Frequencies of vessel reopening were markedly reduced in subjects with diabetes (9.1% vs 66.0% in nondiabetics, p < 0.001) and less so in subjects with additional extracranial carotid occlusion (p = 0.03). Finally, complete recanalization predicted a favorable stroke outcome at day 90 independently of the information provided by age, NIH Stroke Scale, and onset-to-needle time. Conclusions: We found a high rate of vessel recanalization after IV thrombolysis occlusion. However, recanalization was infrequent in patients with diabetes and extracranial carotid occlusion. Information on recanalization was a powerful, early predictor for clinical outcome.