BACKGROUND AND PURPOSE: Patients with acute CTO generally have a poor prognosis, despite IV or IA thrombolytic treatment. The goal of this study was to analyze the results of patients with CTO who had IA urokinase treatment with or without initial IV rtPA based on a bridging protocol. MATERIALS AND METHODS: Sixteen consecutive patients with acute ischemic stroke due to CTO who had combined IV and IA or a single IA thrombolytic treatment were enrolled. The baseline characteristics and prognosis were described. The patients who did and did not develop a PH shortly after treatment were compared. RESULTS: The mean age was 66.4 years, and the median initial NIHSS score was 17. The median dose of IA urokinase was 320,000 U, and recanalization (TICI grade II-III) was achieved in 12 patients (75%). However, 5 patients died and 10 patients had poor prognosis with mRS 5-6 at discharge. Six patients (37.5%) with a PH had a higher NIHSS score 1 day after treatment (26.7 versus 13.6, P = .002), and they had more frequent mortality (66.7% versus 10.0%, P = .018) and worse prognosis (mRS 5-6; 100% versus 40%, P = .016) at discharge than patients without PH. CONCLUSIONS: Patients with CTO who received IA urokinase treatment based on a bridging protocol had a poor prognosis. The development of PH might affect this outcome.
BACKGROUND AND PURPOSE:Patients with acute CTO generally have a poor prognosis, despite IV or IA thrombolytic treatment. The goal of this study was to analyze the results of patients with CTO who had IA urokinase treatment with or without initial IV rtPA based on a bridging protocol. MATERIALS AND METHODS: Sixteen consecutive patients with acute ischemic stroke due to CTO who had combined IV and IA or a single IA thrombolytic treatment were enrolled. The baseline characteristics and prognosis were described. The patients who did and did not develop a PH shortly after treatment were compared. RESULTS: The mean age was 66.4 years, and the median initial NIHSS score was 17. The median dose of IA urokinase was 320,000 U, and recanalization (TICI grade II-III) was achieved in 12 patients (75%). However, 5 patients died and 10 patients had poor prognosis with mRS 5-6 at discharge. Six patients (37.5%) with a PH had a higher NIHSS score 1 day after treatment (26.7 versus 13.6, P = .002), and they had more frequent mortality (66.7% versus 10.0%, P = .018) and worse prognosis (mRS 5-6; 100% versus 40%, P = .016) at discharge than patients without PH. CONCLUSIONS:Patients with CTO who received IA urokinase treatment based on a bridging protocol had a poor prognosis. The development of PH might affect this outcome.
Authors: A Furlan; R Higashida; L Wechsler; M Gent; H Rowley; C Kase; M Pessin; A Ahuja; F Callahan; W M Clark; F Silver; F Rivera Journal: JAMA Date: 1999-12-01 Impact factor: 56.272
Authors: Elad I Levy; Adnan H Siddiqui; Annemarie Crumlish; Kenneth V Snyder; Erik F Hauck; David J Fiorella; L Nelson Hopkins; J Mocco Journal: Stroke Date: 2009-08-20 Impact factor: 7.914
Authors: S M Wolpert; H Bruckmann; R Greenlee; L Wechsler; M S Pessin; G J del Zoppo Journal: AJNR Am J Neuroradiol Date: 1993 Jan-Feb Impact factor: 3.825
Authors: Andreas Kastrup; Klaus Gröschel; Thomas M Ringer; Christoph Redecker; Robert Cordesmeyer; Otto W Witte; Christoph Terborg Journal: Stroke Date: 2008-06-12 Impact factor: 7.914
Authors: David Asuzu; Karin Nyström; Joseph Schindler; Charles Wira; David Greer; Janet Halliday; Kevin N Sheth Journal: Neurocrit Care Date: 2015-10 Impact factor: 3.210
Authors: Seong-Joon Lee; Yang-Ha Hwang; Ji Man Hong; Jin Wook Choi; Dong-Hun Kang; Yong-Won Kim; Yong-Sun Kim; Jeong-Ho Hong; Joonsang Yoo; Chang-Hyun Kim; Bruce Ovbiagele; Andrew Demchuk; Sung-Il Sohn; Jin Soo Lee Journal: Sci Rep Date: 2020-11-30 Impact factor: 4.379