Early partial recanalization after intravenous thrombolysis leads to prediction of favorable outcome in cases of acute ischemic stroke with major vessel occlusion

Publication date: December 2017 Source:Journal of Clinical Neuroscience, Volume 46 Author(s): Jun Young Chang, Hyun Park, Se Young Jang, Seunguk Jung, Hee-Joon Bae, O-Ki Kwon, Moon-Ku Han We investigated the association between early recanalization degree after intravenous thrombolysis (IVT), occurrence of hemorrhagic transformation, and functional outcome. We also evaluated whether recombinant tissue plasminogen activator (rTPA) dosing error could influence the outcome. Patients with ischemic stroke with major vessel occlusion (n=256) who underwent IVT were included. Recanalization status (no recanalization, partial recanalization, and complete recanalization) was confirmed by subsequent magnetic resonance or conventional angiography. Association between early recanalization degree and favorable outcome (modified Rankin Scale score ≤2) was evaluated using logistic regression analysis. Early partial recanalization was achieved in 33 (12.9%), and complete recanalization in 7 (2.7%) patients. Patients with the highest quintile of rTPA dosage achieved complete recanalization more frequently than the lower four quintiles (8.0% vs 2.0%, P=0.03). Hemorrhagic transformation tended to occur more frequently in patients with complete recanalization as compared with patients with partial recanalization (57.1% vs 21.2%, P=0.15). The proportion of favorable outcome was significantly lower in patients with the highest quintile of rTPA dosage used as compared with the patients wi...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research