Free radical scavenger, edaravone, in stroke with internal carotid artery occlusion.
BACKGROUND
Edaravone has potent free radical quenching and antioxidant actions. The agent has been recently in commercial use for acute ischemic stroke patients. In this study, we investigated the therapeutic effect of edaravone on severe carotid-territorial stroke.


METHODS
Stroke patients with internal carotid artery occlusion and baseline NIH Stroke Scale Score > or =15 were treated for 14 days with drip intravenous infusion of edaravone (n=30) and were compared with a historical control cohort of similar patients (n=31). Glycerol was also administered to all patients in both groups.


RESULTS
Infarct volume (P<0.02) and midline shift (P<0.02) on CT performed on day 2 of the patients treated with edaravone were smaller than those without edaravone. For patients with edaravone, infarct volume (P<0.0001) and midline shift (P<0.0001) on days 5-7 were greater than those on day 2. Hemorrhagic transformation of infarcts on day 2 was less severe in patients with than without edaravone (P<0.03). Within 14 days after the onset of stroke, 6 patients with edaravone (20%) and 14 without edaravone (45%) died directly of stroke (P<0.03). Among all patients, only two treated with edaravone were independent without any assistance 8 weeks after the onset.


CONCLUSIONS
Edaravone was associated with delayed evolution of infarcts and edema in patients with severe carotid-territorial stroke and decreased mortality during the acute stage. The agent, however, failed to prevent evolution of infarcts and edema on later days, and did not significantly improve functional outcome among the surviving patients.
Toyoda
Kazunori
K
Department of Cerebrovascular Disease and Clnical Research Institute, National Kyushu Medical Center, Chuo, Fukuoka, Japan. toyoda@qmed.hosp.go.jp
Fujii
Kenichiro
K
Kamouchi
Masahiro
M
Nakane
Hiroshi
H
Arihiro
Shoji
S
Okada
Yasushi
Y
Ibayashi
Setsuro
S
Iida
Mitsuo
M
D000368:Aged; D000983:Antipyrine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications; D001929:Brain Edema / Q000188:drug therapy; D002341:Carotid Artery Thrombosis / Q000188:drug therapy* / Q000401:mortality; D002343:Carotid Artery, Internal; D002544:Cerebral Infarction / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D000077553:Edaravone; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D007839:Functional Laterality; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D016166:Free Radical Scavengers; D000077553:Edaravone; D000983:Antipyrine