IngentaConnect Endovascular neuroradiological treatment of acute ischemic stroke...

Authors: Brekenfeld, Caspar¹; Remonda, Luca¹; Nedeltchev, Krassen¹; v. Bredow, Ferdinand¹; Ozdoba, Christoph¹; Wiest, Roland¹; Arnold, Marcel²; Mattle, Heinrich P.²; Schroth, Gerhard¹

Source: Neurological Research, Volume 27, Supplement 1, October 2005 , pp. 29-35(7)

Publisher: Maney Publishing

Abstract:

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.

Keywords: BRAIN INFARCTION; ENDOVASCULAR THERAPY; HYPOTHERMIA; NEURORADIOLOGY; STROKE; STROKE THERAPY; THROMBOLYSIS; UROKINASE

Document Type: Research article

DOI: 10.1179/016164105X35549

Affiliations: 1: Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Switzerland 2: Clinic of Neurology, University of Bern, Inselspital, Switzerland

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Endovascular neuroradiological treatment of acute ischemic stroke: techniques and results in 350 patients