Intra-arterial thrombolytic therapy in peri-coronary angiography ischemic stroke.
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.
Zaidat
Osama O
OO
Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA. ozaidat@hotmail.com
Slivka
Andy P
AP
Mohammad
Yousef
Y
Graffagnino
Carmelo
C
Smith
Tony P
TP
Enterline
David S
DS
Christoforidis
Greg A
GA
Alexander
Michael J
MJ
Landis
Dennis M D
DM
Suarez
Jose I
JI
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
D005343:Fibrinolytic Agents