Recanalization Rate and its Associated Factors after Intravenous Tissue Plasminogen Activator Thrombolysis for Acute Major Cerebral Arterial Occlusion / 대한뇌혈관외과학회지
Korean Journal of Cerebrovascular Surgery
; : 265-270, 2007.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-118893
Responsible library:
WPRO
ABSTRACT
PURPOSE:
To investigate the recanalization rate after intravenous administration of recombinant tissue plasminogen activator (IV-tPA) for acute major arterial occlusion of the anterior cerebral circulation and to investigate the relationship between atrial fibrillation and recanalization.METHODS:
From April 2005 to April 2006, 16 patients with acute major arterial occlusion of the anterior cerebral circulation were treated with IV-tPA. Recanalization was classified as good (as compared with an unoccluded contralateral vessel; thrombolysis in myocardial infarction (TIMI) classification grade II and III) and poor (TIMI grade 0 and I). The clinical and radiological parameters associated with recanalization were analyzed. The clinical outcomes were evaluated by use of the National Institute of Health Stroke Scale (NIHSS) at 3 months after treatment.RESULTS:
Of all of the 16 patients, 11 patients (68.8%) showed good recanalization. Among these 11 patients, nine patients survived (81.8%). However, only one patient survived (20%, p = 0.036) of the other five patients who showed poor recanalization. The pretreatment NIHSS score and atrial fibrillation were significantly correlated with the recanalization rate. Atrial fibrillation was found in 8 of 16 patients (50.0%) as the cause of the cerebral embolic infarction. Among the patients with atrial fibrillation only three patients showed good recanalization (37.5%); patients without atrial fibrillation showed good recanalization (100%, p = 0.026).CONCLUSIONS:
I.-tPA appears to be effective and safe as a recanalization method for acute major cerebral arterial occlusion in patients that do not have atrial fibrillation. Good recanalization was associated with a good clinical result. Atrial fibrillation is a significant associated factor of poor recanalization and high mortality.
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Cerebrovascular Disease
/
Ischemic Heart Disease
Database:
WPRIM (Western Pacific)
Main subject:
Atrial Fibrillation
/
Mortality
/
Classification
/
Tissue Plasminogen Activator
/
Stroke
/
Administration, Intravenous
/
Infarction
/
Myocardial Infarction
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Journal of Cerebrovascular Surgery
Year:
2007
Document type:
Article