title: Long-term effect of intra-arterial thrombolysis in stroke.
abstract: OBJECTIVE
  Thrombolysis has been shown to improve the 3-month outcome of patients with ischemic stroke, but knowledge of the long-term effect of thrombolysis is limited.
  
  
  METHODS
  The present study compares the long-term outcome of stroke patients who were treated with intra-arterial thrombolysis (IAT) using urokinase with the outcome of patients treated with aspirin. The modified Rankin Scale (mRS) was used to assess the outcome; 173 patients treated with IAT and 261 patients treated with aspirin from the Bernese Stroke Data Bank were eligible for the study. A matching algorithm taking into account patient age and stroke severity on admission (as measured by the National Institute of Health Stroke Scale [NIHSS]) was used to assemble an IAT and an aspirin group.
  
  
  RESULTS
  One hundred and forty-four patients treated with IAT and 147 patients treated with aspirin could be matched and included in the comparative analysis. The median NIHSS score was 14 in each group. At 2 years, 56% of the patients treated with IAT and 42% of the patients treated with aspirin achieved functional independence (mRS, 0 to 2; P=0.037). Clinical outcome was excellent (mRS, 0 to 1) in 40% of the IAT and in 24% of the aspirin patients (P=0.008). Mortality was 23% and 24%, respectively.
  
  
  CONCLUSIONS
  The present study provides evidence for a sustained effect of IAT when assessed 2 years after the stroke.
authors.affiliation: Department of Neurology, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland.
authors.forename: Krassen
authors.initials: K
authors.lastname: Nedeltchev
authors.forename: Urs
authors.initials: U
authors.lastname: Fischer
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
authors.forename: Pietro
authors.initials: P
authors.lastname: Ballinari
authors.forename: Tobias
authors.initials: T
authors.lastname: Haefeli
authors.forename: Liliane
authors.initials: L
authors.lastname: Kappeler
authors.forename: Caspar
authors.initials: C
authors.lastname: Brekenfeld
authors.forename: Luca
authors.initials: L
authors.lastname: Remonda
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D012042:Registries; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors