BACKGROUND AND PURPOSE: The purpose of this study was to evaluate further the efficacy of 0.6 mg/kg intravenous alteplase on vascular and clinical outcomes in patients with middle cerebral artery occlusion in a postmarketing Phase IV trial of prospective cohort study design. METHODS: Alteplase was given intravenously at 0.6 mg/kg to patients with ischemic stroke within 3 hours of onset with MR angiography-documented middle cerebral artery occlusion. Vascular outcome was evaluated by MR angiography at 6 and 24 hours after symptom onset based on the modified Mori grade. The primary end points also included a favorable outcome (modified Rankin Scale 0 to 1 at 3 months after onset) and incidence of symptomatic intracranial hemorrhage within 36 hours after treatment. The impact of recanalization on clinical outcome was assessed by stepwise logistic regression analysis. RESULTS: Fifty-eight patients were enrolled. Recanalization was noted in 51.7% on 6-hour MR angiography and 69.0% on 24-hour MR angiography. A favorable clinical outcome was achieved in 46.6%. None had symptomatic intracranial hemorrhage. In logistic regression models, recanalization on either 6-hour or 24-hour MR angiography was an independent predictor for clinical outcome as well as the baseline National Institutes of Health Stroke Scale score. CONCLUSIONS: Early recanalization of an occluded middle cerebral artery can be provoked by 0.6 mg/kg intravenous alteplase and may induce a favorable clinical outcome. The rates of recanalization and favorable outcome are comparable to that previously reported with the 0.9-mg/kg dose.
BACKGROUND AND PURPOSE: The purpose of this study was to evaluate further the efficacy of 0.6 mg/kg intravenous alteplase on vascular and clinical outcomes in patients with middle cerebral artery occlusion in a postmarketing Phase IV trial of prospective cohort study design. METHODS: Alteplase was given intravenously at 0.6 mg/kg to patients with ischemic stroke within 3 hours of onset with MR angiography-documented middle cerebral artery occlusion. Vascular outcome was evaluated by MR angiography at 6 and 24 hours after symptom onset based on the modified Mori grade. The primary end points also included a favorable outcome (modified Rankin Scale 0 to 1 at 3 months after onset) and incidence of symptomatic intracranial hemorrhage within 36 hours after treatment. The impact of recanalization on clinical outcome was assessed by stepwise logistic regression analysis. RESULTS: Fifty-eight patients were enrolled. Recanalization was noted in 51.7% on 6-hour MR angiography and 69.0% on 24-hour MR angiography. A favorable clinical outcome was achieved in 46.6%. None had symptomatic intracranial hemorrhage. In logistic regression models, recanalization on either 6-hour or 24-hour MR angiography was an independent predictor for clinical outcome as well as the baseline National Institutes of Health Stroke Scale score. CONCLUSIONS: Early recanalization of an occluded middle cerebral artery can be provoked by 0.6 mg/kg intravenous alteplase and may induce a favorable clinical outcome. The rates of recanalization and favorable outcome are comparable to that previously reported with the 0.9-mg/kg dose.
Authors: S Iris Deeds; Andrew Barreto; Jordan Elm; Colin P Derdeyn; Scott Berry; Pooja Khatri; Claudia Moy; Scott Janis; Joseph Broderick; James Grotta; Opeolu Adeoye Journal: Int J Stroke Date: 2020-12-09 Impact factor: 5.266
Authors: Opeolu Adeoye; Heidi Sucharew; Jane Khoury; Achala Vagal; Pamela A Schmit; Irene Ewing; Steven R Levine; Stacie Demel; Bryan Eckerle; Brian Katz; Dawn Kleindorfer; Brian Stettler; Daniel Woo; Pooja Khatri; Joseph P Broderick; Arthur M Pancioli Journal: Stroke Date: 2015-08-04 Impact factor: 7.914
Authors: Xia Wang; Thompson G Robinson; Tsong-Hai Lee; Qiang Li; Hisatomi Arima; Philip M Bath; Laurent Billot; Joseph Broderick; Andrew M Demchuk; Geoffrey Donnan; Jong S Kim; Pablo Lavados; Richard I Lindley; Sheila O Martins; Veronica V Olavarria; Jeyaraj D Pandian; Mark W Parsons; Octavio M Pontes-Neto; Stefano Ricci; Vijay K Sharma; Nguyen H Thang; Ji-Guang Wang; Mark Woodward; Craig S Anderson; John Chalmers Journal: JAMA Neurol Date: 2017-11-01 Impact factor: 18.302
Authors: Eivind Berge; William Whiteley; Heinrich Audebert; Gian Marco De Marchis; Ana Catarina Fonseca; Chiara Padiglioni; Natalia Pérez de la Ossa; Daniel Strbian; Georgios Tsivgoulis; Guillaume Turc Journal: Eur Stroke J Date: 2021-02-19