BACKGROUND AND OBJECTIVES: Randomized trials have demonstrated the benefit of intra-arterial thrombolysis (IAT) for treatment of acute ischemic stroke, if performed within 6 hours of symptom onset. METHODS: We report our experience with 350 acute stroke patients who were treated with IAT using urokinase at a single center. Predictors of favorable outcome were low National Institute of Health Stroke Scale (NIHSS) at admission (p<0.001), good collaterals (p<0.001) and successful endovascular recanalization (p<0.001). Recanalization rates of more than 75% could be achieved, when additional endovascular techniques such as mechanical fragmentation of the thrombus, thromboaspiration, percutaneous transluminal angioplasty, and implantation of stents were used. RESULTS AND CONCLUSIONS: Predictors of unfavorable outcome were diabetes mellitus (p<0.001) and symptomatic hemorrhages (p<0.001). The latter occurred in 5% of our population. Preliminary results of new techniques including sonothrombolysis, angiojet aspiration, and laser recanalization of thromboembolic occlusions are discussed.
BACKGROUND AND OBJECTIVES: Randomized trials have demonstrated the benefit of intra-arterial thrombolysis (IAT) for treatment of acute ischemic stroke, if performed within 6 hours of symptom onset. METHODS: We report our experience with 350 acute strokepatients who were treated with IAT using urokinase at a single center. Predictors of favorable outcome were low National Institute of Health Stroke Scale (NIHSS) at admission (p<0.001), good collaterals (p<0.001) and successful endovascular recanalization (p<0.001). Recanalization rates of more than 75% could be achieved, when additional endovascular techniques such as mechanical fragmentation of the thrombus, thromboaspiration, percutaneous transluminal angioplasty, and implantation of stents were used. RESULTS AND CONCLUSIONS: Predictors of unfavorable outcome were diabetes mellitus (p<0.001) and symptomatic hemorrhages (p<0.001). The latter occurred in 5% of our population. Preliminary results of new techniques including sonothrombolysis, angiojet aspiration, and laser recanalization of thromboembolic occlusions are discussed.
Authors: George J Shaw; Jason M Meunier; Christopher J Lindsell; Arthur M Pancioli; Christy K Holland Journal: Thromb Res Date: 2010-09-01 Impact factor: 3.944
Authors: Fabricio O Lima; Karen L Furie; Gisele S Silva; Michael H Lev; Erica C S Camargo; Aneesh B Singhal; Gordon J Harris; Elkan F Halpern; Walter J Koroshetz; Wade S Smith; Albert J Yoo; Raul G Nogueira Journal: Stroke Date: 2010-09-09 Impact factor: 7.914
Authors: Hans Henkes; Jörg Reinartz; Stephan Lowens; Elina Miloslavski; Christian Roth; Wolfgang Reith; Dietmar Kühne Journal: Neurocrit Care Date: 2006 Impact factor: 3.210
Authors: Albert J Yoo; Javier Romero; Reza Hakimelahi; Raul G Nogueira; James D Rabinov; Johnny C Pryor; R Gilberto González; Joshua A Hirsch; Pamela W Schaefer Journal: BMC Neurol Date: 2010-04-23 Impact factor: 2.474