Document Detail

Intraarterial therapy for acute ischemic stroke: investigation of prognostic factors.
MedLine Citation:
PMID:  17907448     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Intraarterial therapy (IAT) for acute cerebral infarction has been proven to be profitable. However, the criteria for the indications, the choice of the thrombolytic agents, and the use of adjunctive agents are controversial. We retrospectively analyzed the prognostic factors of IAT. MATERIALS AND METHODS: From 1994 to 2003, 28 patients underwent IAT due to middle cerebral artery occlusion (17 women and 11 men; median age, 69 years old). We evaluated the following prognostic parameters: institution of treatment, degree of paralysis at visit, size of high-intensity area on diffusion-weighted images, dose of intraarterial urokinase administration, elapsed time from symptom onset to completion of IAT, presence of penetration of embolus by microcatheter and microguidewire, recanalization after IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenous heparin administration after IAT. The outcome was evaluated at discharge and was classified into the following categories according to the modified Rankin Scale: independence (0 to 2), dependence (3 to 5), and death (6). RESULTS: Seven patients were judged to be independent, 16 patients were judged to be dependent, and five patients died. Patients with recanalization after IAT had a better outcome than those without (p < 0.05); patients with intracranial hemorrhage had a worse outcome than those without (p < 0.05); and patients with intravenous heparin administration after IAT had a better outcome in activities of daily living than those without (p < 0.05). CONCLUSION: In addition to ICH and recanalization, our results suggested that intravenous heparin administration after IAT had a favorable effect on patient outcome.
Tomoyuki Noguchi; Takashi Yoshiura; Shuichi Oguri; Akio Hiwatashi; Osamu Togao; Kouji Yamashita; Eiki Nagao; Junji Murakami; Futoshi Mihara; Hiroshi Honda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Fukuoka igaku zasshi = Hukuoka acta medica     Volume:  98     ISSN:  0016-254X     ISO Abbreviation:  Fukuoka Igaku Zasshi     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-10-02     Completed Date:  2007-11-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9423321     Medline TA:  Fukuoka Igaku Zasshi     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  320-8     Citation Subset:  IM    
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University.
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MeSH Terms
Aged, 80 and over
Combined Modality Therapy
Infarction, Middle Cerebral Artery / therapy*
Injections, Intra-Arterial
Middle Aged
Retrospective Studies
Stroke / therapy*
Urokinase-Type Plasminogen Activator / administration & dosage*
Reg. No./Substance:
EC Plasminogen Activator

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