Document Detail


Angiographic demarcation of an occlusive lesion may predict recanalization after intra-arterial thrombolysis in patients with acute middle cerebral artery occlusion.
MedLine Citation:
PMID:  18304033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The aim of this study is to investigate whether angiographic demarcation of an occlusive lesion may predict successful or failed result of intra-arterial thrombolysis in acute middle cerebral artery (MCA) occlusion. METHODS: We reviewed retrospectively the angiography and clinical data of acute MCA occlusion patients who underwent intra-arterial thrombolysis from 1994 to 2004. Pretreatment angiographic findings at the occlusive lesions were classified as either blurred or sharp, depending on whether the proximal portion of the occlusive lesions had poorly or well demarcated margins. Using uni- or multivariate analysis, recanalization was correlated with our angiographic classification or other clinical variables. RESULTS: Forty-six patients with MCA occlusions underwent intra-arterial thrombolysis during the 10-year period. Forty-four of the angiograms could be classified into one of the two categories: Blurred-type in 20 patients and Sharp-type in 24 patients. Univariate analysis showed a significant association of the classification with recanalization. (Recanalization rate: 95% in Blurred-type and 38% in Sharp-type, P < .0001) Logistic regression analysis showed that the association was independent from other factors (P= .004). CONCLUSION: In acute MCA occlusion, our classification may indicate the difficulty of the recanalization procedure, and may assist in patient triage for different intra-arterial treatment strategies.
Authors:
Yoshinobu Otsuka; Riichiro Waki; Hiroshi Yamauchi; Seiji Fukazawa; Kaku Kimura; Kotoyuki Shimizu; Hidenao Fukuyama
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Publication Detail:
Type:  Journal Article     Date:  2007-11-08
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  18     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-03-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-7     Citation Subset:  IM    
Affiliation:
Human Brain Research Center, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan. otsukay@kuhp.kyoto-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography, Digital Subtraction*
Carotid Stenosis / drug therapy,  radiography
Cerebral Angiography*
Cerebral Hemorrhage / radiography
Female
Fibrinolytic Agents / administration & dosage*
Humans
Infarction, Middle Cerebral Artery / drug therapy*,  radiography*
Infusions, Intra-Arterial
Male
Middle Aged
Middle Cerebral Artery / radiography
Multivariate Analysis
Prognosis
Retrospective Studies
Sensitivity and Specificity
Thrombolytic Therapy*
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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