title: Intra-arterial thrombolytic therapy in peri-coronary angiography ischemic stroke.
abstract: BACKGROUND
  Intra-arterial thrombolysis (IAT) for peri-coronary angiography (CA) stroke may be safe and efficacious. However, IAT may increase the risk of intracranial hemorrhage (ICH).
  
  
  METHODS
  A retrospective study was performed involving 3 university hospitals. All peri-CA IAT-treated cases were identified. Patient demographics, stroke severity, angiographic findings, thrombolytic use, modified Rankin Scale (mRS), ICH, and mortality were determined.
  
  
  RESULTS
  A total of 21 patients with post-left CA stroke were treated with IAT (mean age 71.8+/-12.3 years). Arterial occlusion was found in 14 (66.7%) and 7 (33.3%) of the anterior and posterior circulation, respectively. Mean time-to-therapy was 36+/-12 minutes from the time the neurological deficit was noted. mRS < or =2 occurred in 10 of 21 (48%) patients. Patients with younger age and shorter time-to-IAT had more complete arterial recanalization and clinical recovery. Symptomatic ICH occurred in 3 (14%) cases, and 4 (19%) patients died.
  
  
  CONCLUSIONS
  Peri-CA IAT appears to be feasible and safe without increased risk of symptomatic ICH and death when compared with the previously reported IAT literature.
authors.affiliation: Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA. ozaidat@hotmail.com
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
authors.forename: Andy P
authors.initials: AP
authors.lastname: Slivka
authors.forename: Yousef
authors.initials: Y
authors.lastname: Mohammad
authors.forename: Carmelo
authors.initials: C
authors.lastname: Graffagnino
authors.forename: Tony P
authors.initials: TP
authors.lastname: Smith
authors.forename: David S
authors.initials: DS
authors.lastname: Enterline
authors.forename: Greg A
authors.initials: GA
authors.lastname: Christoforidis
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Alexander
authors.forename: Dennis M D
authors.initials: DM
authors.lastname: Landis
authors.forename: Jose I
authors.initials: JI
authors.lastname: Suarez
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents