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Intravenous tissue plasminogen activator thrombolysis in patients without major arterial occlusion seems to be safe and effective.
MedLine Citation:
PMID:  20948218     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: It is not clear whether tissue plasminogen activator (t-PA) thrombolysis in patients without major arterial occlusion is effective or safe.
METHODS: Consecutive anterior circulation stroke patients treated with t-PA within 3 h of onset were studied. The patients were divided into three groups according to magnetic resonance angiography findings before t-PA infusion: ICA group, ICA occlusion; MCA group, M1 and M2 occlusion, and no occlusion group. Clinical characteristics, the presence of hemorrhagic transformation on T₂* at 24 h after t-PA thrombolysis, and outcome at 3 months were compared among the three groups.
RESULTS: 112 patients were enrolled. The no occlusion group had 21 (18.8%) patients, the ICA group had 29 (25.9%), and the MCA group had 62 (55.4%). The frequency of hemorrhagic transformation was only 4.8% in the no occlusion group (31.0% for the ICA group, and 48.4% for the MCA group, p = 0.0012). At 3 months after t-PA therapy, 61.5% of the no occlusion group had a favorable outcome (modified Rankin score 0-1), which was the highest among the three groups (15.0% for the ICA group, and 41.5% for the MCA group, p = 0.0203).
CONCLUSION: Intravenous t-PA therapy in acute stroke patients without major artery occlusion seems to be safe and effective.
Authors:
Kazumi Kimura; Yasuyuki Iguchi; Kensaku Shibazaki; Yuki Sakamoto; Masao Watanabe
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Publication Detail:
Type:  Journal Article     Date:  2010-10-15
Journal Detail:
Title:  European neurology     Volume:  64     ISSN:  1421-9913     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  258-64     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. kimurak@med.kawasaki-m.ac.jp
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