| Stroke Outcomes of Japanese Patients with Major Cerebral Artery Occlusion in the Post-Alteplase, Pre-MERCI Era. | |
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MedLine Citation:
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PMID: 22721823 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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This study examined outcomes of patients with acute ischemic stroke (AIS) with major cerebral artery occlusion after the approval of intravenous recombinant tissue-type plasminogen activator (IV rt-PA) but before approval of the MERCI retriever. We retrospectively enrolled 1170 consecutive patients with AIS and major cerebral artery occlusion (496 women; mean age, 73.9 ± 12.3 years) who were admitted within 24 hours after the onset of symptoms to 12 Japanese stroke centers between October 2005 and June 2009. Cardioembolism was a leading cause of AIS in this group (68.2%). The occlusion sites of the major cerebral arteries included the common carotid artery and internal carotid artery (ICA; 29.6%), middle cerebral artery (52.2%), and basilar artery (7.6%). Recanalization therapy (RT) was performed in 32.0% of patients (IV rt-PA, 20.0%; neuroendovascular therapy, 9.4%; combined, 2.5%). Symptomatic intracerebral hemorrhage within 36 hours with a ≥1-point increase in the National Institutes of Health Stroke Scale score occurred in 5.3% of the patients. At 3 months (or at hospital discharge), 29.3% of the patients had a favorable outcome (based on a modified Rankin scale score of 0-2), 23.8% were bedridden, and 15.6% died. After multivariate adjustment, RT was positively associated with a favorable outcome and negatively associated with death, whereas age, baseline National Institutes of Health Stroke Scale score, and ICA occlusion were negatively associated with a favorable outcome and positively associated with death. One-third of the patients with AIS and major cerebral artery occlusion were treated with RT, which was independently associated with favorable outcomes and death. However, 40% of the patients became bedridden or died during the post-alteplase, pre-MERCI era in Japan. |
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Authors:
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Kaoru Endo; Masatoshi Koga; Nobuyuki Sakai; Hiroshi Yamagami; Eisuke Furui; Yasushi Matsumoto; Yoshiaki Shiokawa; Shinichi Yoshimura; Yasushi Okada; Jyoji Nakagawara; Toshio Hyogo; Yasuhiro Hasegawa; Hisashi Nagashima; Toshiyuki Fujinaka; Akio Hyodo; Tomoaki Terada; Kazunori Toyoda; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-19 |
Journal Detail:
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Title: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Volume: - ISSN: 1532-8511 ISO Abbreviation: - Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-6-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9111633 Medline TA: J Stroke Cerebrovasc Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cerebrovascular Medicine, Cardiovascular Center, Suita, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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