Document Detail


Intraarterial thrombolysis and stent placement for acute basilar artery occlusion.
MedLine Citation:
PMID:  20688533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study retrospectively the prognostic factors for acute basilar artery occlusion treated with intraarterial thrombolysis and stent placement.
MATERIALS AND METHODS: Within 3-48 hours of disease onset, 52 patients with basilar artery occlusion were treated with emergency intraarterial thrombolysis with recombinant tissue plasminogen activator (rtPA) or urokinase (UK) or intraarterial thrombolysis combined with stent placement. Sixteen patients simultaneously received stent placement for the partial recanalization of basilar artery occlusion after intraarterial thrombolysis. The National Institutes of Health Stroke Scale (NIHSS) scores and the modified Rankin Scale (mRS) scores of the patients were estimated.
RESULTS: A favorable clinical outcome occurred in 22 patients (42.3%), and 20 patients (38.5%) died. The survival rate was 61.5% (32 patients). Successful recanalization of basilar artery occlusion was achieved in 24 patients (46.2%), and partial recanalization was achieved in 16 patients (30.7%). The rate of recanalization was 76.9%. NIHSS scores less than 14, treatment time window less than 24 hours, and a good recanalization were markedly correlated with good clinical prognosis. NIHSS scores less than 14 and treatment time window less than 24 hours were significantly correlated with recanalization. NIHSS scores less than 14 and good recanalization could act as independent predictors for clinical prognosis.
CONCLUSIONS: NIHSS scores less than 14 on admission and successful recanalization can predict favorable outcome for patients with basilar artery occlusion. This study shows that intraarterial thrombolysis and stent placement may be a useful treatment for acute basilar artery occlusion.
Authors:
Yao-Yu Yu; Le Niu; Li Gao; Zhen-Wei Zhao; Jian-Ping Deng; You-Zhi Qu; De-Rang Jiao; Jin-Qing Yang; Guo-Dong Gao
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Publication Detail:
Type:  Journal Article     Date:  2010-08-04
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1359-63     Citation Subset:  IM    
Copyright Information:
Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China. yuyaoyu666@yahoo.com.cn
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Angioplasty, Balloon / adverse effects,  instrumentation*,  mortality
China
Combined Modality Therapy
Disability Evaluation
Female
Fibrinolytic Agents / administration & dosage*,  adverse effects
Humans
Injections, Intra-Arterial
Logistic Models
Male
Middle Aged
Odds Ratio
Recombinant Proteins / administration & dosage
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Stents*
Stroke / drug therapy,  mortality,  therapy*
Survival Rate
Thrombolytic Therapy* / adverse effects,  mortality
Time Factors
Tissue Plasminogen Activator / administration & dosage
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage
Vertebrobasilar Insufficiency / drug therapy,  mortality,  therapy*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Recombinant Proteins; EC 3.4.21.68/Tissue Plasminogen Activator; 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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