PURPOSE: We aimed to assess the safety and effectiveness of mechanical recanalization in patients with ischemic stroke in the anterior circulation within 8 h since symptoms onset and with unknown onset time. We compared time intervals <6 h vs. 6-8 h/unknown onset time, as only limited data are available for a time window beyond 6 h. METHODS: Our cohort included 110 consecutive patients (44 males; mean age, 73.0±11.5 years) with ischemic stroke in the anterior circulation due to the acute occlusion of a large intracranial artery who underwent mechanical recanalization within an 8-hour time window or with unknown onset time. All patients underwent unenhanced computed tomography (CT) of the brain, CT angiography of the cervical and intracranial arteries and digital subtraction angiography. Perfusion CT was performed in patients beyond a 6-hour time window/with unknown onset time. We collected the following data: baseline characteristics, presence of risk factors, neurologic deficit at the time of treatment, time to therapy, recanalization rate, and 3-month clinical outcome. Successful recanalization was defined as Thrombolysis in Cerebral Infarction score of 2b/3 and good clinical outcome as modified Rankin scale value of 0-2 points. RESULTS: Successful recanalization was achieved in 82 patients (74.5%): in 61 patients treated within 6 h (73.5%), 7 patients treated within 6-8 h (63.6%), and 13 patients with unknown onset time (81.3%). Good 3-month clinical outcome was achieved in 61 patients (55.5%): in 46 patients treated within 6 h (55.4%), 5 patients treated within 6-8 h (45.5%), and 10 patients with unknown onset time (62.5%). Recanalization success or clinical outcome were not significantly different between patients treated at different time windows. CONCLUSION: Our data confirms the safety and effectiveness of mechanical recanalization performed in carefully selected patients with ischemic stroke in the anterior circulation within 8 h of stroke onset or with unknown onset time in everyday practice.
PURPOSE: We aimed to assess the safety and effectiveness of mechanical recanalization in patients with ischemic stroke in the anterior circulation within 8 h since symptoms onset and with unknown onset time. We compared time intervals <6 h vs. 6-8 h/unknown onset time, as only limited data are available for a time window beyond 6 h. METHODS: Our cohort included 110 consecutive patients (44 males; mean age, 73.0±11.5 years) with ischemic stroke in the anterior circulation due to the acute occlusion of a large intracranial artery who underwent mechanical recanalization within an 8-hour time window or with unknown onset time. All patients underwent unenhanced computed tomography (CT) of the brain, CT angiography of the cervical and intracranial arteries and digital subtraction angiography. Perfusion CT was performed in patients beyond a 6-hour time window/with unknown onset time. We collected the following data: baseline characteristics, presence of risk factors, neurologic deficit at the time of treatment, time to therapy, recanalization rate, and 3-month clinical outcome. Successful recanalization was defined as Thrombolysis in Cerebral Infarction score of 2b/3 and good clinical outcome as modified Rankin scale value of 0-2 points. RESULTS: Successful recanalization was achieved in 82 patients (74.5%): in 61 patients treated within 6 h (73.5%), 7 patients treated within 6-8 h (63.6%), and 13 patients with unknown onset time (81.3%). Good 3-month clinical outcome was achieved in 61 patients (55.5%): in 46 patients treated within 6 h (55.4%), 5 patients treated within 6-8 h (45.5%), and 10 patients with unknown onset time (62.5%). Recanalization success or clinical outcome were not significantly different between patients treated at different time windows. CONCLUSION: Our data confirms the safety and effectiveness of mechanical recanalization performed in carefully selected patients with ischemic stroke in the anterior circulation within 8 h of stroke onset or with unknown onset time in everyday practice.
Authors: Daniel Sanák; Vladimír Nosál'; David Horák; Andrea Bártková; Kamil Zelenák; Roman Herzig; Jirí Bucil; David Skoloudík; Stanislav Burval; Viera Cisariková; Ivanka Vlachová; Martin Köcher; Jana Zapletalová; Egon Kurca; Petr Kanovský Journal: Neuroradiology Date: 2006-08-29 Impact factor: 2.804
Authors: Bruce C V Campbell; Søren Christensen; Christopher R Levi; Patricia M Desmond; Geoffrey A Donnan; Stephen M Davis; Mark W Parsons Journal: Stroke Date: 2011-10-06 Impact factor: 7.914
Authors: Albert J Yoo; Claus Z Simonsen; Shyam Prabhakaran; Zeshan A Chaudhry; Mohammad A Issa; Jennifer E Fugate; Italo Linfante; David S Liebeskind; Pooja Khatri; Tudor G Jovin; David F Kallmes; Guilherme Dabus; Osama O Zaidat Journal: Stroke Date: 2013-08-06 Impact factor: 7.914
Authors: Bruce C V Campbell; Peter J Mitchell; Timothy J Kleinig; Helen M Dewey; Leonid Churilov; Nawaf Yassi; Bernard Yan; Richard J Dowling; Mark W Parsons; Thomas J Oxley; Teddy Y Wu; Mark Brooks; Marion A Simpson; Ferdinand Miteff; Christopher R Levi; Martin Krause; Timothy J Harrington; Kenneth C Faulder; Brendan S Steinfort; Miriam Priglinger; Timothy Ang; Rebecca Scroop; P Alan Barber; Ben McGuinness; Tissa Wijeratne; Thanh G Phan; Winston Chong; Ronil V Chandra; Christopher F Bladin; Monica Badve; Henry Rice; Laetitia de Villiers; Henry Ma; Patricia M Desmond; Geoffrey A Donnan; Stephen M Davis Journal: N Engl J Med Date: 2015-02-11 Impact factor: 91.245
Authors: W Hacke; M Kaste; C Fieschi; R von Kummer; A Davalos; D Meier; V Larrue; E Bluhmki; S Davis; G Donnan; D Schneider; E Diez-Tejedor; P Trouillas Journal: Lancet Date: 1998-10-17 Impact factor: 79.321
Authors: Chelsea S Kidwell; Reza Jahan; Jeffrey Gornbein; Jeffry R Alger; Val Nenov; Zahra Ajani; Lei Feng; Brett C Meyer; Scott Olson; Lee H Schwamm; Albert J Yoo; Randolph S Marshall; Philip M Meyers; Dileep R Yavagal; Max Wintermark; Judy Guzy; Sidney Starkman; Jeffrey L Saver Journal: N Engl J Med Date: 2013-02-08 Impact factor: 91.245
Authors: Joseph P Broderick; Yuko Y Palesch; Andrew M Demchuk; Sharon D Yeatts; Pooja Khatri; Michael D Hill; Edward C Jauch; Tudor G Jovin; Bernard Yan; Frank L Silver; Rüdiger von Kummer; Carlos A Molina; Bart M Demaerschalk; Ronald Budzik; Wayne M Clark; Osama O Zaidat; Tim W Malisch; Mayank Goyal; Wouter J Schonewille; Mikael Mazighi; Stefan T Engelter; Craig Anderson; Judith Spilker; Janice Carrozzella; Karla J Ryckborst; L Scott Janis; Renée H Martin; Lydia D Foster; Thomas A Tomsick Journal: N Engl J Med Date: 2013-02-07 Impact factor: 91.245